Open Heart Surgery In A Patient With Liver Transplantation: A Case Report

As the number of patients with liver transplantation increased, surgical applications were also frequent due to late-onset heart and other systemic pathologies. The incidence of coronary artery disease is increasing in patients with liver transplantation. Liver transplanted patients are a high risk subgroup for coronary artery disease, even if they are asymptomatic. Coronary artery disease is a predictor of poor outcomes in patients with liver transplantation; therefore, identification of those patients at risk for coronary artery disease should be a key clinical priority. In this study, it was aimed to present coronary artery bypass grafting surgery in a 68-year-old male patient with previous liver transplantation 12 years ago. Coronary artery bypass grafting operation was performed using left internal mammarian artery and autogenous vein graft for three vessels. There was no complication in the pre- and post-operative periods. Coronary artery bypass grafting operation can be performed safely for patients with previous liver transplantaion in experienced centers

The assessment of the relaxant effect of S-nitrosoglutathione on isolated human saphenous vein

S-nitrosothiols (RSNOs) are thought to represent the circulating reservoir of nitric oxide (NO). S-nitrosoglutathione (GSNO) is an endogenous S-nitrosothiol which suggested to be a potent vasodilator with a prolonged relaxant effect compared to the current NO donors that clinically used. There are limited studies about its vascular effects on human vessels while no data is available on its mechanism of action. In this study, we aimed to investigate the acute effect of GSNO on human saphenous vein rings as well as the possible underlying mechanisms. Isolated human saphenous veins obtained from coronary artery bypass surgery, were mounted in an organ bath system, aerated with %5CO2 + %95o 2 at 37o C with a resting tension of 2g. The effect of GSNO (10-8 -10-4 M) were studied in a concentration-dependent manner on rings precontracted submaximally with phenylephrine (3x10-5 M). In order to analyse its mechanism of action, the effects of GSNO were studied in the absence and presence of NO synthase inhibitor, L-NAME (10-4 M, 30min), soluble guanylyl cyclase (sGC) inhibitor, ODQ (10-5 M, 30min) or a selective inhibitor of ATP-sensitive K+ channels (KATP), glibenclamide (10-5 M, 30min). GSNO produced concentration-dependent relaxant effects on precontracted human saphenous veins (Emax: 102,40±1,37%). The prominent relaxant influence of GSNO was not altered in the presence of the inhibitor of NO synthase or KATP channels. While, a significant decrease was observed with ODQ (ODQ-Emax: 43,73±8,61%; Control-Emax:108,4±4,76%, p<0.001, n=5) Our results indicate that acute relaxant effects of GSNO in isolated human saphenous vein were neither mediated by KATP channel activation nor endogenous NO. Whereas, the activation of sGC pathway is likely be involved in this response. A better understanding of the mechanism regulating the vasorelaxant effect of GSNO and its possible role as a new antispasmodic agent for bypass graft spasms will provide us new therapeutic opportunities. Keywords: S-nitrosoglutathione, nitric oxide, coronary artery bypass graft, human saphenous vei