Geschwind H, Boussignac G, Poirot G, Dubois-Rande J L, Pillière R
Service d'Explorations Fonctionnelles, Hôpital Henri-Mondor, Créteil.
Ann Med Interne (Paris). 1989;140(7):557-60.
Coronary autologous blood perfusion may protect the myocardium against ischemia during arterial occlusion due to balloon inflation. During balloon inflation, arterial blood was perfused via the balloon catheter in 19 patients with single proximal severe left anterior descending artery stenosis and normal left ventricular function. Blood was perfused using a contrast medium injector at a flow rate of 40 ml/min. The balloon was maintained inflated for 60 seconds at 6 atmospheres. Two inflations were performed with perfusion and 2 without. Myocardial ischemia was assessed by ST elevations on both the peripheral and intracoronary ECGs, changes in left ventricular systolic and end diastolic pressures and peak positive and negative dP/dt. A positive response was obtained in 11 patients. In 5 patients, the myocardial ischemia induced by dilatation was not alleviated by the perfusion and in 3 patients ischemia was increased by perfusion. In conclusion, ischemia is inconsistently reduced by autologous blood perfusion and its adverse effect in some patients could limit its use.
冠状动脉自体血液灌注可在球囊扩张导致动脉闭塞期间保护心肌免受缺血损伤。在球囊扩张期间，对19例左前降支近端严重狭窄且左心室功能正常的患者，通过球囊导管进行动脉血液灌注。使用造影剂注射器以40 ml/min的流速进行血液灌注。球囊在6个大气压下保持充气60秒。进行了2次有灌注的球囊扩张和2次无灌注的球囊扩张。通过外周和冠状动脉内心电图上的ST段抬高、左心室收缩压和舒张末期压力的变化以及正负dP/dt峰值来评估心肌缺血情况。11例患者获得阳性反应。5例患者中，扩张诱导的心肌缺血未因灌注而缓解，3例患者的缺血因灌注而加重。总之，自体血液灌注对缺血的减轻作用并不一致，其在某些患者中的不良影响可能会限制其应用。
