Document Detail


Myocardial blood supply through a direct left ventricle-coronary artery shunt is not aided by augmented coronary capacitance.
MedLine Citation:
PMID:  15173733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Left ventricle-coronary artery shunting is proposed as an alternative means of myocardial revascularization when standard methods are not an option. During diastole, however, regurgitant coronary flow to the left ventricle decreases the efficacy of the left ventricle-coronary artery shunt. We investigated whether augmented coronary compliance would improve net forward shunt flow. METHODS: In 11 anesthetized pigs a specially designed stent was placed through the lateral wall of the left ventricle. Through an arterial graft, it was connected to the proximal left anterior descending coronary artery. A blind stump of the right internal thoracic artery (15 cm) was anastomosed to the distal left anterior descending coronary artery to serve as added coronary compliance chamber. Blood flow was measured in the coronary artery just distal from the left ventricle-coronary artery shunt, as well as in the shunt and in the compliance chamber entrance-exit. RESULTS: The left ventricle-coronary artery shunt decreased the net forward midcoronary flow to 53% +/- 18% (mean +/- SD) of native flow (8 +/- 4 vs 16 +/- 5 mL/min at baseline, P <.01). The augmented compliance did not significantly increase net forward coronary flow (61% +/- 25% of native flow, P <.01 vs baseline and P =.21 vs left ventricle-coronary artery shunt with normal compliance). The increase in systolic forward flow (53 +/- 23 vs 37 +/- 19 mL/min with normal compliance) was accompanied by a similar increase in diastolic regurgitant flow (-26 +/- 20 vs -16 +/- 16 mL/min). CONCLUSION: In healthy pigs a left ventricle-coronary artery shunt decreased net forward coronary flow to 53% +/- 18% of native flow. Augmentation of coronary artery compliance did not improve shunt performance.
Authors:
Sandra de Zeeuw; Cornelius Borst; Paul F Gründeman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  127     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-02     Completed Date:  2004-07-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1751-8     Citation Subset:  AIM; IM    
Affiliation:
Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Flow Velocity
Coronary Angiography
Coronary Artery Bypass / methods*
Coronary Circulation / physiology*
Coronary Vessels / surgery*
Disease Models, Animal
Female
Hemodynamics / physiology
Male
Myocardial Contraction / physiology
Probability
Sensitivity and Specificity
Swine
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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