Effect of Normothermic Papaverine to Relieve Intraoperative Spasm of the Internal Thoracic Artery

Endothoracic Injection of Room Air for Internal Mammary Artery Harvest

“…First, a simple system to collect the free flow was adopted as described by many authors; however, by using more sophisticated systems, better measurements could be obtained. Second, we studied the indications to prevent the arterial mechanical spasm, but preoperative medications, endogenous catecholamine, body temperature, and cardiac index affect the blood flow of the arterial conduit 14 . This needs further study, but we believe that IMA harvesting with the air insufflation into the endothoracic fascia necessitates less time to dissect and avoids arterial spasm.…”

“…Sasson et al 3 discovered that IMA flow increased spontaneously before the start of cardiopulmonary bypass. Cooper et al 7 and Bilgen et al 13 demonstrated that spontaneous relaxation does not occur between IMA harvest and the start of CPB. Our measurements were performed before the start of CPB and the time was not different between the end of the dissection and the measurement in the groups.…”

Role of physiological state ‘normothermia’ in internal thoracic artery spasm after harvesting

“…Papaverine is one of the most studied vasodilating agents. Bilgen et al [5] showed that topical papaverine at 37 8C produce more increase in free ITA flow than papaverine at 20 8C. They emphasized that enzyme activity induced at 37 8C results in more relaxation.…”

“…In their study, Bilgen et al [5] searched the effect of a potent vasodilator papaverine potentiated by normothermia. Since in normothermia the changing biochemical feature of papaverine potentials the vasodilator effect, we believed that searching the presence of specific effect of normothermia is required to obtain a scientifically accurate result.…”

Recurrent ST-segment elevations in a patient without significant coronary disease

“…If local cold stimulus results in development of coronary artery spasm, local warming to the cooled area may contribute to the alleviation of the spasm. Bilgen et al reported on the internal thoracic artery spasm that normothermic papaverine relieved the coronary artery spasm more effectively than did hypothermic papaverine [17].…”