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Selective arterialization of a cardiac vein in a model of cardiac microangiopathy and macroangiopathy in sheep
- Source :
- The Journal of thoracic and cardiovascular surgery. 133(5)
- Publication Year :
- 2006
-
Abstract
- Objective Some patients with significant arteriosclerosis of the heart are not amenable to revascularization of a coronary artery because they have a combination of microangiopathy and significant macroangiopathy. We investigated the benefit of arterialization of a cardiac vein under these circumstances in an acute animal model. Methods In the hearts of 8 sheep, microspheres were injected into the left coronary artery; 60 minutes later, a stenosis of the left anterior descending artery was performed. After 45 minutes, retrograde venous revascularization was performed by sewing the left internal thoracic artery to the concomitant vein of the left anterior descending artery in a beating-heart technique. For flow reversal, the vein was ligated proximally to the anastomosis. The efficiency of the bypass graft was evaluated by coronary angiography and flow measurement. Cardiac output, electrocardiography, and mean arterial blood pressure were assessed in each phase of the experiment. Results The ischemic state of the myocardium was confirmed by a significant decrease of cardiac output, stroke volume, and mean arterial blood pressure, and a significant elevation of the ST segment in the electrocardiography. After retrograde venous revascularization was established, cardiac output and stroke volume increased and ST elevations decreased. The grafts showed adequate flow (26.15 ± 2.08 mL/min), and reversed blood flow in the grafted vein was proved by coronary angiography. Conclusion Retrograde venous revascularization is possible and improves cardiac function in a state of acute ischemia caused by a combination of microangiopathy and macroangiopathy.
- Subjects :
- Pulmonary and Respiratory Medicine
Cardiac function curve
Male
Cardiac output
medicine.medical_specialty
medicine.medical_treatment
Blood Pressure
Coronary Disease
Revascularization
Coronary Angiography
Veins
Electrocardiography
Left coronary artery
Heart Rate
Internal medicine
medicine.artery
medicine
Myocardial Revascularization
Animals
Cardiac Output
Creatine Kinase
Sheep, Domestic
Cardiac Vein
business.industry
Microangiopathy
Stroke Volume
Stroke volume
medicine.disease
medicine.anatomical_structure
cardiovascular system
Cardiology
Surgery
Female
Cardiology and Cardiovascular Medicine
business
Artery
Subjects
Details
- ISSN :
- 1097685X
- Volume :
- 133
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Accession number :
- edsair.doi.dedup.....6fa41476c6221623b664960464612843