Reference : Nicardipine Protocol for Cabg Using the Radial Artery Clinical and Angiographic Data
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/2268/15668
Nicardipine Protocol for Cabg Using the Radial Artery Clinical and Angiographic Data
English
RADERMECKER, Marc mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
Grenade, Thierry [Université de Liège - ULg > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique]
Cao-Thian, S. K. [> > > >]
Defraigne, Jean-Olivier mailto [Université de Liège - ULg > Département des sciences biomédicales et précliniques > Biochimie générale]
LAVIGNE, Jean-Paul mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
Van Damme, Hendrik [Université de Liège - ULg > Département des sciences cliniques > Département des sciences cliniques]
Kolh, Philippe mailto [Université de Liège - ULg > Département des Sciences biomédicales et précliniques > Service de Biochimie et de Physiologie générales, humaines, normales et pathologiques > >]
Thiry, A. [> >]
Larbuisson, Robert mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Limet, Raymond mailto [Université de Liège - ULg > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique]
2001
Acta Chirurgica Belgica
101
4, Jul-Aug
185-9
Yes
International
0001-5458
[en] The routine use of arterial grafts in coronary surgery is facilitated by peroperative adjunction of antispasmodic drug to reduce the event of spasm. Diltiazem has been favoured in most clinical studies devoted to the radial artery graft. The aim of this study was to assess the efficacy of a spasm preventing protocol associating hydrostatic dilation of the graft with a diluted solution of papaverine and nicardipine infusion, starting preoperatively and continued postoperatively in i.v. and per os forms. Between September 1996 and March 1997, a consecutive series of 50 patients underwent myocardial revascularization using the radial artery. The radial artery was prepared by hydrostatic dilation with papaverine (1%) and nicardipine was administrated at 0.25 microgram/kg/min and titrated according to the arterial systemic pressure. Operative mortality was 4% (sepsis). There was no evidence of perioperative MI nor hypoperfusion syndrome. Mean CKMB level at 18 hours was 36 micrograms/l. No ischaemic anomalies of the ECG were detected. Angiography performed in the last 20 patients showed a 98% (51/52) permeability rate for all graft; 19/20 radial grafts (95%) were patent. One radial graft presented a 50% stenosis at the proximal anastomosis, and another a moderate spasm (40%) in the middle part of the conduit. This study confirms that the radial artery conduit can be used with satisfactory results for routine coronary artery bypass. The use of nicardipine allows the control the vasoreactivity of the radial graft without totally obviating at least angiographic spasm. This drug is easy to titrate, and well tolerated in association to beta-blockers in the routine perioperative management of the coronary patients.
Professionals
http://hdl.handle.net/2268/15668
also: http://hdl.handle.net/2268/161026

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