The Search of the Effects of Verapamil and Papaverin on LIMA Graft Flow in Beating Heart Coronary Bypass Surgery

Yıl 2010, Cilt: 13 Sayı: 3, 5 - 9, 01.03.2009

İbrahim Sami Karacan Ömer Ulular Kanat Özışık U¤ursay K›z›ltepe

Öz

The Search of the Effects of Verapamil and Papaverin on LIMA Graft Flow in Beating Heart Coronary Bypass Surgery Purpose: The most important problem encountered during the preparation phase of LIMA as being the most important graft which is used in coronary surgery and the same problem after this phase is vasospasm of LIMA. In this study, we evaluated the effects of two vasodilator drugs on LIMA flow which are used on patients in beating heart coronary artery bypass surgery. Material and Method: 40 patients were investigated who were undergone beating heart coronary artery bypass surgery. Their average age was 61.50± 11.76. The patients were divided in two groups according to applied vasodilator drugs (papaverin and verapamil groups). The existence of DM, TA and ACT values were recorded during blood flows measurement. The findings: Statistical difference was determined in male patients when compared to female patients (for verapamil p=0.037, for papaverin p=0.042) and in patients with high TA when compared to patients with low TA in the measurements done just before topical drug application and LIMA anastomoses (for verapamil, before drug application p=0.001, after drug application p=0.046, for papaverin before drug application p=0.012, after drug application p=0.021). In both groups, statistically important LIMA blood flow rises were seen after topical drug injection. However papaverin was superior to verapamil when ratio of their ability of increasing blood flow was taken into account (p=0.045). Conclusion: We concluded that short-timed warm bathing process with papaverin increased LIMA blood flow in comparison with the same process done with verapamil; besides, we saw that to keep TA high raises LIMA flow regardless of what kind of vasodilator drugs are used. We claim that, to use papaverin instead of verapamil as topical drug and to keep TA high peroperatively will be beneficial to LIMA flow just after LIMA greft was harvested in patients undergone beating heart coronary artery bypass surgery.

Anahtar Kelimeler

Coronary artery bypass, beating heartcoronary bypass, vasospasm, vasodilation, papaverine, verapamile

Atan Kalpte Koroner Baypas Cerrahisinde Papaverin ve Verapamilin L‹MA Grefti Ak›m› Üzerine Olan Etkilerinin ‹ncelenmesi

Öz

Amaç: Koroner arter cerrahisinde kullan›lan en önemli greft olan sol internal mamariyan arter (L‹MA)'n›n haz›rlanmas› nda ve sonras›nda karfl›lafl›lan en önemli sorun L‹MA spazm›d›r. Bu çal›flmada, atan kalpte koroner baypas (OPCAB) hastalar›nda kulland›¤›m›z iki vazodilatör ajan›n L‹MA ak›m› üzerine olan etkilerini de¤erlendirdik. Materyal ve Metod: OPCAB yap›lan 40 hasta çal›flmaya al›nd›. Hastalar›n yafl ortalamas› 61.50 ± 11.76 y›l idi. Hastalar uygulanan vazodilatör ajana göre iki gruba ayr›ld› (papaverin ve verapamil gruplar›). Kan ak›m ölçümleri esnas› nda diyabetes mellitus (DM) varl›¤›, tansiyon arteriyel (TA) ve aktive edilmifl p›ht›laflma zaman› (ACT) de¤erleri ölçülerek kaydedildi. Bulgular: Topikal ilaç uygulamas›ndan önce ve L‹MA anastomoz edilmeden hemen önce yap›lan ölçümlerde gruplar aras›nda erkek hastalarda kad›n hastalara göre (verapamil için p=0.037, papaverin için p=0.042) ve TA yüksek olan hastalarda TA de¤eri düflük olan hastalara göre (verapamil için ilaç uygulama öncesi p=0.001, ilaç uygulama sonras› p=0.046, papaverin için ilaç uygulama öncesi p=0.012, ilaç uygulama sonras› p=0.021) istatistiksel olarak anlaml› farkl›l›k gözlendi (p

Anahtar Kelimeler

Koroner arter baypas cerrahisi, atan kalpte baypas, vazospazm, vazodilatasyon, papaverin, verapamil

Kaynakça

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