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The Journal of Cardiovascular Surgery 2022 February;63(1):69-77

DOI: 10.23736/S0021-9509.21.11796-3


language: English

Comparative study of coronary artery bypass graft materials: reduced contraction and ADMA levels in internal mammary artery versus saphenous vein

Gulsev OZEN 1 , Khadija ALJESRI 1, Gulsum TURKYILMAZ 2, Saygin TURKYILMAZ 2, Ali A. KAVALA 2, Gokce TOPAL 1, Xavier NOREL 3

1 Department of Pharmacology, Faculty of Pharmacy, University of Istanbul, Istanbul, Turkey; 2 Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Education and Research Hospital Bakirkoy, Istanbul, Turkey; 3 Eicosanoids and Vascular Pharmacology Group, Université de Paris, INSERM U1148, Paris, France

BACKGROUND: Vasospasm and atherosclerosis due to low endothelial capacity are the most important causes of coronary artery bypass graft failure observed in internal mammary artery (IMA) and saphenous vein (SV). Vasospasm can be mimicked in in-vitro studies by inducing vasoconstriction of graft materials. In the present study, we aimed to compare the vascular contraction induced by several spasmogens including prostaglandin E2 (PGE2), prostaglandin F2 alpha (PGF), phenylephrine (PE), leukotriene C4 (LTC4), LTD4, potassium chloride (KCl), and arachidonic acid between IMA and SV preparations. Furthermore, endothelial capacity, nitrite and asymmetric dimethylarginine (ADMA) levels were compared between two grafts.
METHODS: By using organ bath, contractile responses induced by different spasmogens were compared between IMA and SV preparations derived from patients underwent coronary artery bypass surgery (N.=35). The endothelial capacity was determined by acetylcholine-induced (ACh) relaxation in PE-precontracted vessels. Nitrite and ADMA levels were measured in organ culture supernatant of IMA and SV preparations.
RESULTS: Contractile responses induced by PGE2, PGF, PE, LTC4, LTD4, KCl and arachidonic acid were significantly lower in IMA preparations versus SV preparations. ACh-induced relaxation was significantly more prominent in IMA than SV preparations. Nitrite levels were greater and ADMA levels were lower in IMA versus SV preparations.
CONCLUSIONS: IMA has reduced capacity to constrict to several vasoconstrictor agents. Furthermore, IMA has greater endothelial capacity associated with higher nitrite levels and lower ADMA levels. Our results support the greater patency rate observed in IMA versus SV preparations.

KEY WORDS: Saphenous vein; Mammary arteries; Blood vessels; Coronary artery bypass; Prostaglandins; Leukotrienes

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