ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Louis P. Perrault
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Perrault, L. P.
Right arrow Articles by Mommerot, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Perrault, L. P.
Right arrow Articles by Mommerot, A.
Related Collections
Right arrow Coronary disease

Ann Thorac Surg 2007;83:515-516
© 2007 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Invited commentary

Louis P. Perrault, MD, PhD, Arnaud Mommerot, MD

Department of Surgery, Montreal Heart Institute, 5000 Belanger St, Montreal, Quebec, H1T1C8 Canada

(Email: louis.perrault{at}icm-mhi.org).

Arterial conduits are increasingly used for coronary artery bypass grafting surgery (CABG). Their superior long-term patency rate, compared with venous grafts, make them the conduits of choice for myocardial revascularization. However, both radial arteries (RAs) and internal mammary arteries (IMAs) are prone to a dreaded complication, the vasospasm. In vitro studies help to elucidate the pathophysiological mechanisms involved and may improve the perioperative management of these grafts to prevent occurrence of such adverse events. In this article, Rabbani and associates [1] address the basis of the regulation of IMA and RA contraction by extracellular and intracellular calcium, and by cyclic AMP (cAMP). They demonstrate that the contraction elicited by thromboxane A2 (TXA2), and by the {alpha}-adrenoreceptor agonist, phenylephrine (both released during CABG with cardiopulmonary bypass) have different mechanisms. Although the TXA2 analog, U46619, induces contraction through combined extracellular calcium influx and intracellular calcium release, phenylephrine induces contraction mainly through an extracellular calcium influx. These data suggest that calcium channel blockers may not be useful in preventing TXA2-induced vasospasm. On the other hand, the cAMP signaling pathway does not seem to be affected by TXA2. Thus, pharmacological agents maintaining a high cAMP level, either by increasing its production or by preventing its degradation, are likely to be useful in this situation.

This study brings new insights to the pathophysiology of arterial graft spasm in the perioperative period and suggests an interest for certain pharmacological drug classes in preventing graft contraction elicited by endogenous TXA2 release, including phosphodiesterase III inhibitors (such as milrinone) or adenylate cyclase activators (such as forskolin) used here. Although this type of in vitro study gives insight into the operative mechanisms shortly after graft implantation, further work (both bench and clinical) should address the optimal long-term drug management of the RA as a graft conduit.


   References
Top
 References
 

  1. Rabbani G, Vijay V, Sarabu MR, Gupte SA. Regulation of human internal mammary and radial artery contraction by extra- and intra-cellular Ca2+ and by cAMP Ann Thorac Surg 2007;83:510-516.[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
I. A. Tarhan, T. Kehlibar, Y. Arslan, M. Yilmaz, M. Dumantepe, K. Berkoz, C. Pancaroglu, and A. Ozler
Effects of normothermic organ bath and verapamil nitroglycerin solution alone or in combination on the blood flow of radial artery
Eur. J. Cardiothorac. Surg., October 1, 2007; 32(4): 617 - 622.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Louis P. Perrault
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Perrault, L. P.
Right arrow Articles by Mommerot, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Perrault, L. P.
Right arrow Articles by Mommerot, A.
Related Collections
Right arrow Coronary disease

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS