Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Nafamostat Mesilate: Can It Be Used as a Conduit Preserving Agent in Coronary Artery Bypass Surgery?

  • Yoon, Yoo Sang (Department of Thoracic Surgery, Dongnam Institute of Radiological and Medical Science) ;
  • Oh, Hyunkong (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine) ;
  • Kim, Yonghwan (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine) ;
  • Lim, Seung Pyung (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine) ;
  • Kim, Cuk-Seong (Department of Physiology, Chungnam National University School of Medicine) ;
  • Kang, Min-Woong (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine)
  • Received : 2013.07.15
  • Accepted : 2013.08.05
  • Published : 2013.12.05
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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.

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References

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