{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:38:28Z","timestamp":1787071108275,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>In this study, we aimed at a comparative quantitative estimation of the difference in LIMA blood flow between LIMAs treated with topical papaverine alone and LIMAs treated with a combination of topical papaverine plus an intraluminal cocktail of papaverine, nitroglycerine, and milrinone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Nearly 50 consecutive patients with similar demographics undergoing elective on-pump CABG were recruited for the study. After pedicled LIMA harvest, topical papaverine was sprayed on the pedicle and kept enveloped in papaverine soaked gauze. LIMA flow was then estimated. Later, intraluminal vasodilator solution of papaverine, NTG, milrinone, and heparinized blood were instilled in LIMA, and LIMA flows were estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean LIMA flows with topical papaverine alone was 47.19 mL\/min whereas the mean LIMA flows with topical papaverine plus intraluminal cocktail was 104 mL\/min. There was a significant difference between the two flows as their mean was 56.815 mL\/min and the paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test for significance had a\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value of 0.0001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There was a significant difference in the LIMA flow when the LIMA had been treated with the intraluminal instillation of the vasodilator cocktail in addition to the topical application of papaverine solution. Therefore, intraluminal vasodilator cocktail of milrinone, NTG, and papaverine mixed with heparinized blood in addition to topical papaverine is a simple and effective method for LIMA preparation in CABG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_164_19","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T07:18:01Z","timestamp":1613114281000},"page":"414-418","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Quantitative Estimation of LIMA Blood Flow between Extraluminal Papavarine vs Extraluminal Papavarine Plus Intraluminal Vasodilator Cocktail in CABG Patients"],"prefix":"10.4103","volume":"23","author":[{"given":"Vivek V","family":"Pillai","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renjith","family":"Sreekanthan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayakumar","family":"Karunakaran","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,19]]},"reference":[{"key":"R1-20250921","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1067\/mtc.2000.107280","article-title":"Isolated bypass grafting of the left internal thoracic artery to the left anterior descending coro- nary artery: Late consequences of incomplete revascularization","volume":"120","author":"Scott","year":"2000","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R2-20250921","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJM198601023140101","article-title":"Influence of the internal mammary artery graft on 10-year survival and other cardiac events","volume":"314","author":"Loop","year":"1986","journal-title":"N Engl J Med"},{"key":"R3-20250921","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/S0003-4975(10)62041-3","article-title":"Early postoperative spasm in left internal mammary artery bypass grafts","volume":"44","author":"Sarabu","year":"1987","journal-title":"Ann Thorac Surg"},{"key":"R4-20250921","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.athoracsur.2015.09.071","article-title":"Spasm in arterial grafts in coronary artery bypass grafting surgery","volume":"101","author":"He","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"R5-20250921","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.athoracsur.2016.03.017","article-title":"Antispastic management in arterial grafts in CABG","volume":"102","author":"He","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"R6-20250921","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.ejcts.2006.09.001","article-title":"Role of physiological state \u2018normothermia\u2019 in internal thoracic artery spasm after harvesting","volume":"30","author":"Tarhan","year":"2006","journal-title":"Euro J Cardiothorac Surg"},{"key":"R7-20250921","first-page":"543","article-title":"The art of arterial revascularization\u2014total arterial revascularization in patients with triple vessel coronary artery disease","volume":"2","author":"Buxton","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"R8-20250921","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0003-4975(03)01331-6","article-title":"Patencies of 2127 arterial to coronary conduits over 15 years","volume":"77","author":"Tatoulis","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"R9-20250921","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.athoracsur.2007.10.008","article-title":"Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: Findings from PREVENT IV","volume":"85","author":"Magee","year":"2008","journal-title":"Ann Thorac Surg"},{"key":"R10-20250921","first-page":"893","article-title":"Interventions for coronary stenosis\u2014A Canadian experience of 30 revolutionary years","volume":"12","author":"FitzGibbon","year":"1996","journal-title":"Can J Cardiol"},{"key":"R11-20250921","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0022-5223(19)34463-0","article-title":"Preparation of the internal mammary artery graft? 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