Use of verapamil and nitroglycerin solution in preparation of radial artery for coronary grafting

Potent Vasodilatory Effect of Fasudil on Radial Artery Graft in Coronary Artery Bypass Operations

“…A cocktail of verapamil and nitroglycerin (VG solution) has been extensively studied. He and Yang [15] and Dogan et al [22] reported good vasodilatory effect for RA. Yoshizaki et al [23] also reported that VG solution is a superior vasodilator based on postoperative imaging studies.…”

“…This solution gives a concentration of 30 μmol/L each of verapamil and nitroglycerin in an isotonic solution at pH 7.4. This concentration was determined based on a previous study using VG solution to prepare RA for CABG [15]. Ten minutes after injection of the vasodilator, GFF of the RA graft was again measured for 60 seconds.…”

Pharmacology of Arterial Grafts for Coronary Artery Bypass Surgery

“…It is still widely used due to its satisfactory vasorelaxant effect in arterial grafts [61,62]. Papaverine is a non specific vasodilator substance which relaxes vessels via multiple mechanisms such as inhibition of phosphodiesterase [63], which increases cyclic guanosine monophosphate (cGMP) level in smooth muscle cells, decreasing calcium influx [64,65] or inhibition of release of intracellularly stored calcium [66].…”

“…However, the pharmacological action is uncertain in such a mixture. Additionally, papaverine has a slower onset of the vasodilating effect when compared to other vasodilators such as nitroglycerin (NTG) and verapamil [10,62,72]. However, once its effect reaches a plateau, it is sustained [10,62,72].…”

“…Additionally, papaverine has a slower onset of the vasodilating effect when compared to other vasodilators such as nitroglycerin (NTG) and verapamil [10,62,72]. However, once its effect reaches a plateau, it is sustained [10,62,72]. Papaverine hydrochloride is relatively unstable in non-acidic solutions and a white precipitate is sometimes formed when papaverine is added to the plasmalyte solution (pH approximately 7.4) [73].…”