Investigation of the vasorelaxant effects of 3-(5′-hydroxymethyl-2′-furyl)-1-benzyl indazole (YC-1) and diethylamine/nitric oxide (DEA/NO) on the human radial artery used as coronary bypass graft

2007 ◽  
Vol 85 (5) ◽  
pp. 521-526 ◽  
Author(s):  
Ocal Berkan ◽  
Ihsan Bagcivan ◽  
Tijen Kaya ◽  
Kemal Yildirim ◽  
Sahin Yildirim ◽  
...  

The radial artery (RA) is used as a spastic coronary bypass graft. This study was designed to investigate the mechanism of vasorelaxant effects of YC-1 (3-(5′-hydroxymethyl-2′-furyl)-1-benzyl indazole), a nitric oxide (NO)-independent soluble guanylate cyclase (sGC) activator, and DEA/NO (diethylamine/nitric oxide), a NO-nucleophile adduct, on the human RA. RA segments (n = 25) were obtained from coronary artery bypass grafting patients and were divided into 3–4 mm vascular rings.Using the isolated tissue bath technique, the endothelium-independent vasodilatation function was tested in vitro by the addition of cumulative concentrations of YC-1 (10−10 to 3 × 10−7 mol/L) and DEA/NO (10−8 to 3 × 10−5 mol/L) following vasocontraction by phenylephrine in the presence or absence of 10−5 mol/L ODQ (1H-(1,2,4)oxadiazole(4,3-a)quinoxalin-1-one), the selective sGC inhibitor, 10−7 mol/L iberiotoxin, a blocker of Ca2+-activated K+ channels, or 10−5 mol/L ODQ plus 10−7 mol/L iberiotoxin. We also evaluated the effect of YC-1 and DEA/NO on the cGMP levels in vascular rings obtained from human radial artery (n = 6 for each drug). YC-1 (10−10 to 3 × 10−7 mol/L) and DEA/NO (10−8 to 3 × 10−5 mol/L) caused the concentration-dependent vasorelaxation in RA rings precontracted with phenylephrine (10−5 mol/L) (n = 20 for each drug). Pre-incubation of RA rings with ODQ, iberiotoxin, or ODQ plus iberiotoxin significantly inhibited the vasorelaxant effect of YC-1, but the inhibitor effect of ODQ plus iberiotoxin was significantly more than that of ODQ and iberiotoxin alone (p < 0.05). The vasorelaxant effect of DEA/NO almost completely abolished in the presence of ODQ and iberiotoxin plus ODQ, but did not significantly change in the presence of iberiotoxin alone (p > 0.05). The pEC50 value of DEA/NO was significantly lower than those for YC-1 (p < 0.01), with no change Emax values in RA rings. In addition, YC-1-stimulated RA rings showed more elevation in cGMP than that of DEA/NO (p < 0.05). These findings indicate that YC-1 is a more potent relaxant than DEA/NO in the human RA. The relaxant effects of YC-1 could be due to the stimulation of the sGC and Ca2+-sensitive K+channels, whereas the relaxant effects of DEA/NO could be completely due to the stimulation of the sGC. YC-1 and DEA/NO may be effective as vasodilator for the short-term treatment of perioperative spasm of coronary bypass grafts.

Author(s):  
engin akgül ◽  
Abdulkerim Ozhan

Background: One of the most undesired complications after open heart operations is bleeding. In our study, we set ourselves two different goals: examining ‘Papworth, Will-Bleed, Track and Trust’ bleeding scoring systems to determine the most predictive one among diabetic patients undergoing isolated coronary bypass surgery, and determining the variables that should be included in the new scoring systems to be established for this patient group. Methods: The files of 297 diabetic patients who underwent isolated coronary artery bypass operation between 2017-2019 were retrospectively reviewed. Patients who underwent emergency surgery with a beating heart, those with reoperated open hart surgery, those with ticagrelor use, and those who died within the first 24 postoperative hours were excluded from the study. Drainage from the thorax and mediastinal tubes and blood product transfusions to the patients within the first 24 hours were noted and analyzed according to scoring systems. Results: Scoring systems are evaluated based on ‘European Multicenter Study on Coronary Artery Bypass Grafting Bleeding Severity (E-CABG)’. In this study including diabetic patients only, Papworth was better predictive of E-CABG bleeding Grade 2-3. We found that Will-Bleed, Track, Trust, the other scoring systems we examined had discriminatory value in terms of E-CABG bleeding Grade 2-3 in our study group. Among the parameters in the scoring systems, we concluded that gender, preoperative hemoglobin (or hematocrit) value, preoperative platelet count, use of antiplatelets until less than five days prior to the operation, and preoperative creatinine (or eGFR) values should be included in the scoring system we aim to establish in the future, called the “Optimum Risk Score for Bleeding (ORS).” Conclusion: Considering the possible risks of bleeding and blood product transfusion, scoring systems that will provide accurate results for patient blood management will be lifesaving and increase the cost-effectiveness of the treatment.


2015 ◽  
Vol 149 (4) ◽  
pp. 1036-1040 ◽  
Author(s):  
Ozge Korkmaz ◽  
Bülent Saraç ◽  
Sabahattin Göksel ◽  
Sahin Yildirim ◽  
Ocal Berkan ◽  
...  

2015 ◽  
Vol 21 (3) ◽  
pp. 342-345 ◽  
Author(s):  
Bulent Sarac ◽  
Ozge Korkmaz ◽  
Ahmet Altun ◽  
Ihsan Bagcivan ◽  
Sabahattin Göksel ◽  
...  

2002 ◽  
Vol 39 (4) ◽  
pp. 573-577 ◽  
Author(s):  
Mahmoud H. Al-Bustami ◽  
M. Amrani ◽  
Adrian H. Chester ◽  
Charles J. Ilsley ◽  
Magdi H. Yacoub

2020 ◽  
Author(s):  
Reda Bzikha ◽  
Gautier Charles Henri

Coronary–coronary bypass graft was first performed by Rowland and Grooters. This technique can be performed between two segments of the same coronary artery using saphenous vein grafts or free arterial grafts in on/off-pump coronary artery bypass grafting, also can be an alternative safe technique in some cases as calcified ascending aorta, porcelain aorta and insufficient graft length. The coronarycoronary bypass graft can provide nearly the same flow rate as conventional coronary artery bypass graft, another advantage this technique is that we can use to decrease sternal and respiratory morbidity. we performed this technique to a 55-year-old woman to whom coronary angiography showed critical three-vessel disease, using a free segment of right internal mammary artery, combined to conventional coronary artery bypass graft. The postoperative course was uneventful with the absence of ischemic lesions and the grafts were patent at 6 months after procedure.


Author(s):  
I. Yu. Sigaev ◽  
M. A. Keren ◽  
A. V. Kazaryan ◽  
I. V. Pilipenko ◽  
G. G. Getsadze

Coronary artery bypass graft (CABG) using short-scar incision (without median sternotomy) allows minimizing the invasiveness of the intervention, reducing the risks of postoperative complications, and also ensuring patient comfort and quick social and physical rehabilitation. The successful implementation of such operations is due not only to surgical skills and the integration of technological achievements into practice, but also to the appropriate selection of patients. The article presents a clinical case of successful re-operation of the subclavian-coronary artery bypass grafting on a beating heart using antero-lateral thoracotomy approach in a patient with angina relapse after CABG.


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