+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Effect of normothermic papaverine to relieve intraoperative spasm of the internal thoracic artery



Effect of normothermic papaverine to relieve intraoperative spasm of the internal thoracic artery



Annals of Thoracic Surgery 62(3): 769-771



Background. After mobilization, vasospasm often reduces flow through the internal thoracic artery. An established method of relaxing the artery and increasing flow is to use papaverine at ambient temperature (20 degree to 22 degree C) as a topical vasodilator. However, the pharmacologic actions of papaverine generally have been assessed at 37 degree C. Methods. In 60 patients in whom the left internal thoracic artery was used for myocardial revascularization, we investigated the effects of normal saline solution at 20 degree C (group I), papaverine at 20 degree C (group II), and papaverine at 37 degree C (group III). Under controlled hemodynamic conditions, free flow was measured before any pharmacologic intervention and a median of 16 minutes after the pedicle had been sprayed with one of the agents. Results. Normal saline solution at 20 degree C produced a small increase in flow from 37.5 +- 8.1 mL/min to 50 +- 10.2 mL/min. A significant increase occurred with papaverine at 20 degree C, from 38.05 +- 6.3 mL/min to 78.75 +- 21.2 mL/min (p lt 0.0001). Papaverine at 37 degree C, however, produced an increase in flow from 36.9 +- 12.6 mL/min to 103.3 +- 44.6 mL/min (p lt 0.0001) and proved to be more effective than papaverine at room temperature (p = 0.0174). Conclusions. We recommend topical use of papaverine at 37 degree C to relieve intraoperative spasm of the internal thoracic artery.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 008540448

Download citation: RISBibTeXText

PMID: 8784006

DOI: 10.1016/s0003-4975(96)00441-9


Related references

Internal thoracic artery spasm and normothermic papaverine. Annals of Thoracic Surgery 64(4): 1219-1220, 1997

Intractable postoperative internal thoracic artery spasm managed with angiographic intraluminal papaverine. Journal of Thoracic and Cardiovascular Surgery 130(3): 938-940, 2005

Intraoperative duplex study of internal thoracic artery spasm during coronary bypass. Journal of Cardiac Surgery 12(6): 403-405, 1997

Mechanism of the effect of theophylline and papaverine on the spasm of the internal carotid artery. Patologicheskaia Fiziologiia i Eksperimental'naia Terapiia 1974(6): 16-19, 1974

Intraoperative papaverine effect on human internal mammary artery contraction and relaxation. Clinical Science 81(4): 23P, 1991

The mechanism of the effects of theophylline and papaverine on the spasm of the internal carotid artery. Patologicheskaya Fiziologiya I Eksperimental'Naya Terapiya:, 1974

T grafts with the right internal thoracic artery to left internal thoracic artery versus the left internal thoracic artery and radial artery: Flow dynamics in the internal thoracic artery main stem. Journal of Thoracic and Cardiovascular Surgery 118(5): 841-848, 1999

Use of topical sodium nitroprusside to relieve perioperative spasm of the internal mammary artery: a word of caution. Journal of Thoracic and Cardiovascular Surgery 108(2): 387, 1994

Papaverine delivery to the internal mammary artery pedicle effectively treats spasm. Annals of Thoracic Surgery 78(4): 1295-1298, 2004

Pharmacokinetics of intraluminally administered serum papaverine for spasm prophylaxis of the internal mammary artery. Heart Surgery Forum 16(5): E266, 2013

Papaverine hydrodissection of internal thoracic artery. Asian Cardiovascular and Thoracic Annals 15(6): 542, 2007

The best application modus of papaverine to the internal thoracic artery. Circulation 92(8 Suppl. ): I177, 1995

Internal thoracic artery response to papaverine: takes time. European Journal of Cardio-Thoracic Surgery 27(4): 726; Author Reply 726-7, 2005

Endothoracic papaverine application for internal thoracic artery harvest. Asian Cardiovascular and Thoracic Annals 15(3): 234-237, 2007