Nafamostat Mesilate: Can It Be Used as a Conduit Preserving Agent in Coronary Artery Bypass Surgery?.
- Author:
Yoo Sang YOON
1
;
Hyunkong OH
;
Yonghwan KIM
;
Seung Pyung LIM
;
Cuk Seong KIM
;
Min Woong KANG
Author Information
1. Department of Thoracic Surgery, Dongnam Institute of Radiological and Medical Science, Korea.
- Publication Type:Original Article
- Keywords:
Coronary artery bypass surgery;
Coronary artery bypass conduits;
Anticoagulants
- MeSH:
Acetylcholine;
Animals;
Anticoagulants;
Aorta, Thoracic;
Apoptosis;
Baths;
Coronary Artery Bypass*;
Coronary Vessels*;
DNA Nucleotidylexotransferase;
Endothelial Cells;
Guanidines;
Human Umbilical Vein Endothelial Cells;
Mesylates*;
Necrosis;
Papaverine;
Perioperative Period;
Phenylephrine;
Rats;
Rats, Sprague-Dawley;
Relaxation;
Survival Rate;
Transplants;
Vasodilation
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2013;46(6):413-425
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Graft vessel preservation solution in coronary artery bypass surgery is used to maintain the graft conduit in optimal condition during the perioperative period. Nafamostat mesilate (NM) has anticoagulation and anti-inflammatory properties. Therefore, we investigated NM as a conduit preservative agent and compared it to papaverine. METHODS: Sprague-Dawley (SD) rat thoracic aortas were examined for their contraction-relaxation ability using phenylephrine (PE) and acetylcholine (ACh) following preincubation with papaverine and NM in standard classical organ baths. Human umbilical vein endothelial cells (HUVECs) were cultured to check for the endothelial cell viability. Histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end labeling assay were performed on the thoracic aortas of SD rats. RESULTS: The anti-contraction effects of papaverine were superior to those of NM at PE (p<0.05). The relaxation effect of NM on ACh-induced vasodilatation was not statistically different from that of papaverine. Viability assays using HUVECs showed endothelial cell survival rates of >90% in various concentrations of both NM and papaverine. A histopathological study showed a protective effect against necrosis and apoptosis (p<0.05) in the NM group. CONCLUSION: NM exhibited good vascular relaxation and a reasonable anti-vasocontraction effect with a better cell protecting effect than papaverine; therefore, we concluded that NM is a good potential conduit preserving agent.
