CARDIAC SURGERY / RESEARCH PAPER
Effects of botulinum toxin A and papaverine on human saphenous vein and internal mammary artery grafts: an in vitro study
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1
Necmettin Erbakan University, Meram Faculty of Medicine, Department of Medical Pharmacology
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Necmettin Erbakan University, Meram Faculty of Medicine, Department of Cardiovascular Surgery
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Necmettin Erbakan University, Department of Pathology
CORRESPONDING AUTHOR
Ipek Duman   

Necmettin Erbakan University, Meram Faculty of Medicine, Department of Medical Pharmacology
Submission date: 2019-02-24
Final revision date: 2019-06-11
Acceptance date: 2019-06-21
Online publication date: 2021-03-24
 
Arch Med Sci 2022;18(6)
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Autologous saphenous vein (SV) and internal mammary artery (IMA) are used as bypass conduits during coronary artery bypass graft surgery. Vasospasm of the arterial and venous grafts may constitute a significant clinical problem. Pretreatment with a vasodilator drug of the graft ex vivo or intraluminal injection before implantation may be used for spasm prophylaxis. This in-vitro study was designed to assess the vasoactive effects and time-dependent changes of botulinum toxin A (BTX-A) and papaverine pretreatment on vasospasm of human SV and IMA grafts. Also histomorphology of the vessels were assessed.

Material and methods:
SV and IMA segments were suspended in organ baths and isometric contraction responses to two different concentrationsof 5-hydroxytryptamine (5-HT) and endothelin-1 (ET-1) were recorded after incubation with two different concentrations of BTX-A and papaverine at two time points (0 hours and 2nd hour).

Results:
The results suggest that; 1) incubation with BTX-A and papaverine relaxes both SV and IMA rings contracted with 5-HT and ET-1, 2) duration of the relaxant effect of BTX-A lasts longer than papaverine, 3) no apparent histomorphologic changes are observed in the grafts under light microscopy.

Conclusions:
This study demonstrates that in human SV and IMA grafts, pretreatment with both BTX-A and papaverine are safe and have a potent inhibitory effect depending on the vessel and vasoconstrictor agent. Long lasting vasodilatory effect of BTX-A on vascular smooth muscle may provide promising results for preventing venous and arterial graft spasm.

eISSN:1896-9151
ISSN:1734-1922