Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Apr 2001
Comparative Study Clinical Trial Controlled Clinical TrialEffect of papaverine applications on blood flow of the internal mammary artery.
The aim of this prospective study was to compare the effect of different papaverine applications on the free blood flow in the internal mammary artery (IMA) prepared for coronary artery bypass grafting (CABG). The patients were divided into three groups: group I (n=50; intraluminal papaverine application), group II (n=50; topical papaverine application), and group III (n=50; periarterial papaverine application). The free flow from the distal cut end of the IMA was measured under controlled hemodynamic conditions (Flow 1). ⋯ After papaverine application, the mean blood flow in group I was 129.3+/-10.0 ml/min, in group II, it was 87.7+/-3.8 ml/min, and in group III, it was 130.6+/-9.2 ml/min (p<0.0001). Proportional increases in blood flow observed in group I (106.3%) and group III (116.2%) were higher than in group II (44.2%) (p<0.0001). Consequently, to relieve perioperative spasm of the IMA, application of papaverine injected into the periarterial tissues of its pedicle was considered to be a safe and effective alternative to topical or intraluminal application.
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Ann Thorac Cardiovasc Surg · Apr 2001
Shape and movement of the interatrial septum predicts change in pulmonary capillary wedge pressure.
We aimed to assess whether movement of the interatrial septum predicts change in pulmonary capillary wedge pressure (PCWP). In 71 patients undergoing cardiac surgery, the interatrial septum was categorised by its shape and movement using transesophageal echocardiography. Fixed curvature (FC) was identified by bowing of the interatrial septum from left to right throughout the cardiac cycle, mid-systolic reversal (MSR) by minimal septal movement and transient reversal (right to left) during mid-systole, and mid-systolic buckling (MSB) by marked movement and buckling of the septum during mid-systole. ⋯ The mean PCWP at which a change in pattern occurred was 8.9 mmHg (8.3 to 9.6) for MSR to MSB, and 10.9 mmHg (10.1 to 11.8) for MSR to FC (p<0.001). There was no significant difference in mean values for all three observers. Movement of the interatrial septum predicts change in PCWP.