Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer?
The three main conduits used for myocardial revascularization in patients with coronary artery disease (CAD) are the internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV). In coronary artery bypass grafting (CABG) conduits may be harvested with perivascular adipose tissue (PVAT)...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2025.1539102/full |
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| author | Michael R. Dashwood Zeynep Celik Gokce Topal |
| author_facet | Michael R. Dashwood Zeynep Celik Gokce Topal |
| author_sort | Michael R. Dashwood |
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| description | The three main conduits used for myocardial revascularization in patients with coronary artery disease (CAD) are the internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV). In coronary artery bypass grafting (CABG) conduits may be harvested with perivascular adipose tissue (PVAT) intact (pedicled) or removed (skeletonized). Various studies have shown that the patency rate of these bypass grafts may be affected by the preservation or removal of PVAT. Vasospasm is often encountered at harvesting, a condition that has both immediate and long term effects on graft performance. During surgery a variety of antispastic solutions are routinely used on conduits that have anti-contractile and/or vasorelaxant actions. Spasm may be abolished or reduced when PVAT is left intact at harvesting and this is particularly the case for the SV. The protective properties of PVAT are multifactorial, ranging from its mechanical properties in supporting the graft after implantation to the beneficial effect of adipocyte-derived factors. This review aims to outline the possible mechanisms through which preserved PVAT could alleviate vasospasm and improve conduit performance in CABG. Moreover, since preservation of PVAT reduces spasm at and after surgery this review also considers whether antispastic solutions are needed if conduits are harvested with PVAT intact. |
| format | Article |
| id | doaj-art-5ba44b78d34c4ab8bb5d9f5ba04d72ca |
| institution | Kabale University |
| issn | 1664-042X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physiology |
| spelling | doaj-art-5ba44b78d34c4ab8bb5d9f5ba04d72ca2025-01-31T06:40:00ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-01-011610.3389/fphys.2025.15391021539102Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer?Michael R. Dashwood0Zeynep Celik1Gokce Topal2Surgical and Interventional Sciences, Royal Free Hospital Campus, University College Medical School, London, United KingdomDepartment of Pharmacology, Istanbul University Faculty of Pharmacy, Istanbul, TürkiyeDepartment of Pharmacology, Istanbul University Faculty of Pharmacy, Istanbul, TürkiyeThe three main conduits used for myocardial revascularization in patients with coronary artery disease (CAD) are the internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV). In coronary artery bypass grafting (CABG) conduits may be harvested with perivascular adipose tissue (PVAT) intact (pedicled) or removed (skeletonized). Various studies have shown that the patency rate of these bypass grafts may be affected by the preservation or removal of PVAT. Vasospasm is often encountered at harvesting, a condition that has both immediate and long term effects on graft performance. During surgery a variety of antispastic solutions are routinely used on conduits that have anti-contractile and/or vasorelaxant actions. Spasm may be abolished or reduced when PVAT is left intact at harvesting and this is particularly the case for the SV. The protective properties of PVAT are multifactorial, ranging from its mechanical properties in supporting the graft after implantation to the beneficial effect of adipocyte-derived factors. This review aims to outline the possible mechanisms through which preserved PVAT could alleviate vasospasm and improve conduit performance in CABG. Moreover, since preservation of PVAT reduces spasm at and after surgery this review also considers whether antispastic solutions are needed if conduits are harvested with PVAT intact.https://www.frontiersin.org/articles/10.3389/fphys.2025.1539102/fullperivascular adipose tissuesaphenous veininternal thoracic arteryradial arteryvasospasmantispastic solutions |
| spellingShingle | Michael R. Dashwood Zeynep Celik Gokce Topal Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer? Frontiers in Physiology perivascular adipose tissue saphenous vein internal thoracic artery radial artery vasospasm antispastic solutions |
| title | Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer? |
| title_full | Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer? |
| title_fullStr | Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer? |
| title_full_unstemmed | Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer? |
| title_short | Reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery: are solutions the solution or is preserved perivascular fat the answer? |
| title_sort | reducing vasospasm of vein and arterial conduits used in coronary artery bypass surgery are solutions the solution or is preserved perivascular fat the answer |
| topic | perivascular adipose tissue saphenous vein internal thoracic artery radial artery vasospasm antispastic solutions |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2025.1539102/full |
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