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Ann Thorac Surg 2000;69:84-89
© 2000 The Society of Thoracic Surgeons

Original Articles

LV-powered coronary sinus retroperfusion reduces infarct size in acutely ischemic pigs

Jeffrey S. Martin, MDa, John G. Byrne, MDa, Olivier Y. Ghez, MDa, Umer Sayeed-Shah, MDa, Sergey D. Grachev, MDa, Rita G. Laurence, BSa, Lawrence H. Cohn, MDa

a Division of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

Address reprint requests to Dr Byrne, Division of Cardiac Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115
e-mail: jgbyrne{at}bics.bwh.harvard.edu

Background. We developed a prosthetic left ventricle (LV) to coronary sinus (CS) shunt (LVCSS) that is autoregulating and provides LV-powered retrograde perfusion of the coronary sinus.

Methods. Each of 20 Yorkshire pigs underwent 1 hour of left anterior descending diagonal artery occlusion followed by 3 hours of reperfusion. The controls (n = 5) did not have shunt treatment. The LVCSS group (n = 9) underwent shunt treatment during the ischemic period. The LVCSS with partial coronary sinus occlusion (PCSO) group (LVCSS+PCSO, n = 6) underwent shunt treatment and PCSO during the ischemic period. Vital staining and planimetry techniques were used to determine the area at risk for infarction and the area of necrosis.

Results. The area at risk was not significantly different among groups. The area of necrosis was decreased by 53% in the LVCSS group and by 73% in the LVCSS+PCSO group when compared to controls (p < 0.01 among all groups).

Conclusions. The LVCSS reduces infarct size in pigs after acute coronary artery occlusion. The addition of PCSO to LVCSS further improves myocardial salvage.




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