Selective arterialization of the coronary venous system. Encouraging long-term flow evaluation utilizing radioactive microspheres
The long-term effectiveness of a retrograde coronary venous bypass graft (CVBG) to an ischemic left ventricle was evaluated in 18 dogs. A saphenous vein was interposed between the aorta and left anterior descending (LAD) vein. The LAD vein was ligated cephalad to the CVBG to prevent an arteriovenous fistula. The LAD artery was ligated at its origin to create anterior wall ischemia. Operative graft flow averaged 53 ml. per minute. The 14 surviving dogs were catheterized 3 to 5 months later. Ten of the 14 CVBG's were patent angiographically. The chests were opened and graft flow now averaged 50 ml. per minute. /sup 141/Ce microspheres were injected into the left atrium to measure myocardial flow to the anterior wall. In the 10 dogs with patent grafts, transmural flow was 39 +- 1 (S.E.M.) ml. per 100 Gm. of tissue per minute. The endocardial/epicardial flow ratio was 1.4/1, indicating that retrograde venous perfusion effectively delivered blood to the subendocardium. After ligation of the CVBG, microsphere measured flow dropped to 15 +- 1 ml. per 100 Gm. per minute. In 15 control dogs, anterior wall flow was 100 +- 3 ml. per 100 Gm. per minute, decreasing to 13 +- 2 ml. 45 minutes after ligation of the LAD artery and vein. None of the eight control dogs with simple ligation of the LAD artery and vein survived more than 5 days. Histologic examination of the anterior wall of the left ventricle, the area served by the CVBG's for 3 to 5 months, disclosed no evidence of venous sclerosis or thrombosis and no evidence of interstitial edema or hemorrhage. Thus a CVBG permitted long-term survival in an otherwise nonviable anatomic preparation. Moreover, restoration of flow with a CVBG was effective because it perfused all layers of the myocardium, especially the subendocardium - the crucial layer of myocardial muscle.
- Research Organization:
- National Heart, Lung, and Blood Inst., Bethesda, MD
- OSTI ID:
- 7097687
- Journal Information:
- J. Thorac. Cardiovasc. Surg.; (United States), Vol. 77:1
- Country of Publication:
- United States
- Language:
- English
Similar Records
Pressure-flow characteristics and nutritional capacity of coronary veins in dogs
Thallium-201 scintigraphy in complete left bundle branch block
Related Subjects
BLOOD FLOW
TRACER TECHNIQUES
MYOCARDIUM
ARTERIES
CERIUM 141
DOGS
HEART
ISCHEMIA
MICROSPHERES
VEINS
ANIMALS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CERIUM ISOTOPES
DAYS LIVING RADIOISOTOPES
DISEASES
EVEN-ODD NUCLEI
INTERMEDIATE MASS NUCLEI
ISOTOPE APPLICATIONS
ISOTOPES
MAMMALS
MUSCLES
NUCLEI
ORGANS
RADIOISOTOPES
RARE EARTH ISOTOPES
RARE EARTH NUCLEI
VASCULAR DISEASES
VERTEBRATES
551001* - Physiological Systems- Tracer Techniques