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Ann Thorac Surg 1999;67:878-888
© 1999 The Society of Thoracic Surgeons
a Cardiac Surgical Research Laboratory, Baker Medical Research Institute and Alfred Hospital, Prahran, Australia
c Department of Cardiac Surgery, Austin and Repatriation Medical Centre, Heidelberg, Australia
d Department of Pharmacology, University of Melbourne, Melbourne, Victoria, Australia
b Department of Cardiothoracic Surgery, University of Hong Kong, Grantham Hospital, Hong Kong, China
Address reprint requests to Dr Rosenfeldt, Baker Medical Research Institute, PO Box 6492, St Kilda Road Central, Melbourne, Victoria 8008 Australia
e-mail: frank.rosenfeldt{at}baker.edu.au
Spasm of arterial and venous graft conduits can occur both during harvesting and after the graft is connected. Attempts to overcome spasm during harvesting by probing or hydraulic distension can cause structural damage to the graft, which may impair short- and long-term patency. After a coronary artery bypass graft is connected, spasm can cause major problems with myocardial perfusion. To select the best pharmacologic agent to prevent or reverse vasoconstriction in a graft requires an understanding of the reactivity of that particular type of graft to vasoconstrictor and vasodilator agents. The pharmacologic reactivity of venous and arterial graft conduits has been documented through extensive studies of isolated vessels in the organ bath and of in situ grafts in the body. In this review we summarize the current state of knowledge of the reactivity of arterial and venous grafts to vasoconstrictor and vasodilator agents and describe the practical application of this knowledge in the operating room and in the postoperative period.
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