Improved Preservation of Saphenous Venous Conduits by the Use of Papaverine mixed heparinized blood Solution during Harvesting.
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Date
2011
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Abstract
Background: High-pressure distension during harvesting damages the saphenous vein (SV) and
may contribute to subsequent coronary artery bypass graft (CABG) occlusion. Application of
vasodilator agents to the SV during harvesting may reduce the need for high-pressure distension
and improve graft quality. We tested the effects of a vasodilator solution containing the conventional
agent papaverine (Pap) mixed with heparinized blood on the pressure necessary to overcome SV
spasm and on the structure.
Methods: 150 patients undergoing CABG were nonrandomly allocated to receive an application of
either intraluminal papaverine (Pap) mixed with heparinized blood(Group-A), or intraluminal
heparin mixed normal saline(group-B) to the SV for distension during harvesting. The peak pressures
required to distend the vein were recorded. Samples of SV were taken for microscopical analysis just
before we performed the anastomosis.
Results: The results for mean peak pressures (mm Hg) were: Normal saline 131.77±20.6 (range 85
to199 mmHg); and Papaverine mixed blood solution, 56.4±2.1 (range 40 to 90 mmHg); P<0.001, (Pap
mixed blood solution versus normal saline); The results of histological study for endothelial injury
were: Normal saline, 52.5 %; Papaverine mixed blood solution , 20%; (P<.02, untreated versus Pap
mixed blood solution).
Conclusions: Intraluminal use of Papaverine mixed heparinized blood solution during vein
harvesting requires low distension pressure and improves endothelial coverage compared with the
use of heparin mixed normal saline.
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Keywords
Venous Grafts, CABG, Papaverine
Citation
Maruf M F, Sabur S A M A, Akter T, Hakim E, Ahsan N A K. Improved Preservation of Saphenous Venous Conduits by the Use of Papaverine mixed heparinized blood Solution during Harvesting. Cardiovascular Journal. 2011; 4(1): 3-7.