Open chest and open pericardium affect the distribution of myocardial blood flow in the right ventricle.

We have investigated the effects of open chest and open pericardium on the distribution of myocardial blood flow assessed with the radioactive microsphere technique (15 microns). Five dogs with intact thorax served as controls (group I) and six dogs were studied after a right-sided thoracotomy and pericardiotomy (group II). Global myocardial blood flow (mean +/- S.D.) was 0.73 +/- 0.17 ml.min-1.g-1 in group I and 1.22 +/- 0.09 ml.min-1.g-1 in group II (p less than 0.05). Analysis of transmural blood flow distribution revealed that flow was 44% higher in the right and 60% higher in the left ventricular endocardial layers in the open-chest animals, whereas epicardial flow increased by 105% and 90%, respectively. As a result of the preferential blood flow to the epicardial layers of the right ventricle, the endo/epi ratio was reduced from 1.30 +/- 0.26 in group I to 0.86 +/- 0.11 in the open-chest group (p less than 0.05). Left ventricular endo/epi ratio was 1.27 +/- 0.16 and 1.06 +/- 0.11 (n.s.), respectively. External work and diastolic filling pressure of the right ventricle did not differ between the two groups and therefore cannot account for the redistribution of myocardial blood flow. It is concluded that the distribution of myocardial blood flow, particularly in the RV, is severely disturbed by thoracotomy and pericardiotomy. This is an important aspect for the planning and evaluation of studies under open-chest/open-pericardium conditions.