Differences in vasoreactivity between gastroepiploic artery grafts late after bypass surgery and grafted coronary arteries.

摘要: BACKGROUND: The gastroepiploic artery is increasingly used as an alternative arterial coronary bypass conduit. In vitro studies have reported differences in vasoreactivity among various types of graft conduits, susceptible to influencing the adaptation myocardial blood flow and long-term patency rate. METHODS AND RESULTS: To evaluate vivo grafts implanted long-term, nine angiographically smooth distal right or left circumflex were studied with quantitative angiography 6 36 months after surgery. Angiograms obtained on 35mm cinefilms basal conditions, injection methylergometrine (0.4 mg IV), intragraft 1 isosorbide dinitrate. there was no difference luminal diameter between arteries (1.64 +/- 0.32 versus 1.51 0.31 mm; P = NS). After methylergometrine, a constriction observed all (-14 6% diameter) but one grafted (-6 5%). dinitrate, dilation consistently (+26 9%) (+14 7% basal). Changes lumen response these constrictor dilator stimuli, either expressed absolute values percentage control significantly greater (P < .001) than arteries. CONCLUSIONS: Gastroepiploic are more reactive ergometrine nitrates. This differs from that previously internal mammary same pharmacological vasoactive stimuli. suggests concept efficient endothelium-dependent vasomotor tone contributing better functional results cannot be directly extrapolated grafts.