Effects of normothermic organ bath and verapamil–nitroglycerin solution alone or in combination on the blood flow of radial artery

Tarhan, Ibrahım Arif; Kehlіbar, Tamer; Arslan, Yucesin; Yılmaz, Mehmet; Dumantepe, Mert; Berköz, Kazım; Pancaroglu, Cansin; Özler, Azmi

doi:10.1016/j.ejcts.2007.06.039

Cited by 8 publications

(9 citation statements)

References 26 publications

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“…In a study with 20 patients, Tarhan et al [6] compared the use of scissors, electrocautery, and ultrasonic cautery for harvesting time, spasm, and electron microscopic endothelium examination and found all the results between the groups to be similar.…”

Section: Discussionmentioning

confidence: 99%

“…It is often recommended to prepare the RA with the accompanying veins within the pedicle in order to prevent the occurrence of spasm. Harmonic scalpel (Harmonic scalpel ® , HS, Ethicon Endo-Surgery, Cincinnati, Ohio) and electrocautery (Petaş ® Profesyonel Elektronik, Ankara, Turkey) are reported to be suitable devices for this technique [6] . Skeletonized harvesting of RA using sharp dissection is a less frequently used method [7,8] .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Sharp Dissection, Electrocautery, and Ultrasonic Activated Scalpel with Regard to Endothelial Damage, Preparation Time, and Postoperative Bleeding During Radial Artery Harvesting

Uysal¹,

Gülmen²,

Özkan³

et al. 2019

Braz J Cardiovasc Surg

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ObjectiveTo examine the effects of classical technique, electrocautery, and ultrasonic dissection on endothelial integrity, function, and preparation time for harvesting the radial artery (RA) during coronary artery bypass grafting (CABG).MethodsForty-five patients who underwent isolated CABG and whose RA was suitable for use were studied and divided into three groups: Group 1, classical method (using sharp dissection); Group 2, electrocautery; and Group 3, ultrasonic cautery. Levels of prostacyclin and nitric oxide derivatives were examined biochemically; vascular cell adhesion molecule 1 (VCAM-1) and endothelial nitric oxide synthetase (eNOS) values were assessed using immunohistochemical staining. RA preparation time, RA length/harvesting time ratio, and drainage amounts at the site of RA removal were compared.ResultsDifferences in RA preparation time (Group 1: 25±6 min, Group 2: 18±3 min, Group 3: 16±3 min, P<0.001) and length/harvesting time ratio (Group 1: 0.76±0.19 cm/min, Group 2: 0.98±0.16 cm/min, Group 3: 1.13±0.09 cm/min, P<0.001) were statistically significant among the groups. Levels of prostacyclin and nitric oxide derivatives were not statistically significant different, VCAM-1 and eNOS expressions were observed to be similar among the groups, and endothelial damage was detected in only one patient per group.ConclusionUse of ultrasonic cautery during RA preparation considerably reduces the preparation time and postoperative drainage amount. However, the superiority of one method over the others could not be demonstrated when the presence of endothelial damage with both biochemical and histopathological evaluations was considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Sharp Dissection, Electrocautery, and Ultrasonic Activated Scalpel with Regard to Endothelial Damage, Preparation Time, and Postoperative Bleeding During Radial Artery Harvesting

Uysal¹,

Gülmen²,

Özkan³

et al. 2019

Braz J Cardiovasc Surg

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“…The organ bath technique is mainly used for preventing radial artery spasm as described in previous studies. 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

Use of nitroglycerin and verapamil solution by organ bath technique in preparation of left internal thoracic artery for coronary artery bypass surgery

Mohapatra

Mishra

Saxena

et al. 2017

Indian Heart Journal

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BackgroundThe aim of this prospective study was to compare the effect of application of nitroglycerin and verapamil solution (GV) by organ bath technique with other methods of applications and solutions on the free blood flow of LITA. The technique was not described for in situ graft before.MethodThe patients were randomly assigned to four groups: group I (n_32, GV solution by organ bath technique), group II (n_30, papaverine solution by organ bath technique), group III (n_29, topical GV solution) or group IV (n_29, topical papaverine solution). In each patient, pedicled LITA was harvested; thereafter applied with the randomized different methods and solutions. The free flow from the distal end of the divided LITA was measured for 15 s under controlled hemodynamic conditions after harvesting (Flow 1). The flow of LITA was measured again just prior to anastomosing the conduit (Flow 2).ResultThe mean blood flow in LITA was 56.2 ± 5.0 ml/min before application of solutions. After application, the mean blood flow in group I:102.3 ± 7.0 ml/min, in group II: 92.7 ± 3.4 ml/min, and in group III: 88.6 ± 2.2 ml/min and in group IV: 81.4 ± 2.1. Proportional increases in blood flow observed in group I (82.6%) > group II (65.1%) > group III (57.6) > group IV (44.8%) (p < 0.05).ConclusionsGV solution by organ bath technique is effective and superior in comparison to use of papaverine using organ bath technique or topical spray of GV or papaverine solution.

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“…Schena et al (5) reported a case of the nongrafted right coronary artery spasm treated with decisive balloon dilatation and stent insertion, which was intractable with intracoronary infusion of nitroglycerin and CCB. As observed in the Tarhan and colleagues' study, to prevent spasm of grafting artery, donor vessel should be manipulated carefully to minimize surgical trauma during harvest, endothelial injury must be avoided by maintaining the blood flow until just before distal anastomosis, body temperature and temperature of harvested vessel have to be strictly controlled as normothermia, and medication such as nitroglycerin and/or CCB also should be applied systemically or topically (7). …”

Section: Discussionmentioning

confidence: 99%

Native Coronary Artery and Grafted Artery Spasm Just after Coronary Artery Bypass Grafting: A Case Report

2010

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Effects of normothermic organ bath and verapamil–nitroglycerin solution alone or in combination on the blood flow of radial artery

Abstract: Hypothermia plays an important role in radial artery vasospasm. Normothermic organ bath and verapamil-nitroglycerin solution alone or in combination relieve spasm of radial artery.

Cited by 8 publications

References 26 publications

Comparison of Sharp Dissection, Electrocautery, and Ultrasonic Activated Scalpel with Regard to Endothelial Damage, Preparation Time, and Postoperative Bleeding During Radial Artery Harvesting

Comparison of Sharp Dissection, Electrocautery, and Ultrasonic Activated Scalpel with Regard to Endothelial Damage, Preparation Time, and Postoperative Bleeding During Radial Artery Harvesting

Use of nitroglycerin and verapamil solution by organ bath technique in preparation of left internal thoracic artery for coronary artery bypass surgery

Native Coronary Artery and Grafted Artery Spasm Just after Coronary Artery Bypass Grafting: A Case Report

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