BIOCHEMICAL AND ULTRASTRUCTURAL INTEGRITY OF THE SAPHENOUS-VEIN CONDUIT DURING CORONARY-ARTERY BYPASS-GRAFTING - PRELIMINARY-RESULTS OF THE EFFECT OF PAPAVERINE

Google Scholar
  • 1 January 1984
    • journal article
    • research article
    • Vol. 88  (1) , 39-48
Abstract
Factors associated with early and late graft patency related to aorta-coronary artery bypass grafting with a reversed segment of saphenous vein are clinically important. The present investigation examines the biochemical and EM integrity of this venous conduit intraoperatively with regard to pharmacologic manipulation with papaverine. Portions of saphenous vein were analyzed in 22 patients undergoing coronary artery bypass operations. Levels of a stable derivative of prostacyclin, 6-keto-PGF1.alpha. [6-keto-prostaglandin F-1-alpha] were measured by radioimmunoassay. Scanning as well as transmission electron microscopy was also performed. The efficacy of local vein treatment with papaverine, a phosphodiesterase inhibitor, was evaluated. Levels of 6-keto-PGF1.alpha. in venous effluent showed a biphasic response with initial elevation followed by a relative depression after papaverine exposure. There were no such changes observed in veins subjected to a balanced electrolyte solution (Plasma-Lyte). Levels of the platelet-inhibitory substance 6-keto-PGF1.alpha. in venous tissue were less in papaverine-treated veins than those found in veins treated only with Plasma-Lyte. Evidence for ultrastructural damage was also somewhat greater in the papaverine-treated group. An alternative method of dilating the saphenous vein after harvesting, which involves the creation of the proximal aorta-coronary anastomosis first and then gentle finger manipulation, appeared to minimize venous injury. Some amount of injury apparently is inevitable during harvesting and suturing of the human saphenous vein during coronary bypass grafting.

This publication has 10 references indexed in Scilit: