Papaverine Injures the Endothelium of the Internal Mammary Artery

Abstract

Intraluminal injection of papaverine may be employed to dilate the internal mammary artery for use as a coronary artery bypass graft. The biochemical and morphological consequences of exposing the endothelium of the internal mammary artery to papaverine have been investigated. Biochemical injury was assessed by measuring changes in basal and vortex-stimulated prostaglandin I₂ production, and morphological damage by scanning electron microscopy. Segments of internal mammary artery from 10 patients were placed In one of three solutions; papaverine (1.5 mg/ml of normal saline), normal saline acidified to the pH of the papaverine solution, and normal saline alone. Basal production of prostaglandin l₂ was similar in the three groups but vortex-stimulated production was significantly lower in segments stored In papaverine (18.3pg/mg) and acidified saline (19.1 pg/mg) compared with that of saline alone (43.6pg/mg). No consistent morphological difference was found by scanning electron microscopy. It was concluded that the low pH of the papaverine solution injured the endothelium of the internal mammary artery.