Solorzano J, Taitelbaum G, Chiu R C
Ann Thorac Surg. 1978 Mar;25(3):201-8. doi: 10.1016/s0003-4975(10)63522-9.
The pathophysiology of retrograde coronary sinus perfusion was studied in a vented, nonworking heart in vitro. The fraction of nutritional blood flow, estimated with the trapping index of radioactive microspheres (15 +/- 5 mu), is approximately one-fifth of total flow. The funoff is primarily through the thebesian system and venovenous channels, as is shown with Microfil injection studies. These results suggest that retrograde coronary sinus perfusion would be of marginal value in revascularizing a working heart but would be effective in protecting a hypothermic, nonworking myocardium. Canine experiments indicate that retrograde coronary sinus perfusion can provide efficient core cooling of the myocardium during cardiopulmonary bypass even in the presence of complete coronary artery occlusion. It is technically simple, delivers cardioplegic solutions to the myocardium without the risk of coronary ostial injury, and can be employed in the presence of severe aortic insufficiency and open aortic root. Retrograde coronary sinus perfusion therefore appears to be a valuable alternative mode of myocardial protection during cardiac operations.
在体外通气的无功能心脏中研究了逆行冠状静脉窦灌注的病理生理学。用放射性微球（15±5微米）的捕获指数估计的营养血流量约为总血流量的五分之一。如用微管注射研究所示，引流主要通过心最小静脉系统和静脉-静脉通道。这些结果表明，逆行冠状静脉窦灌注在为有功能的心脏进行血管重建方面价值有限，但在保护低温无功能心肌方面有效。犬实验表明，即使在冠状动脉完全闭塞的情况下，逆行冠状静脉窦灌注在体外循环期间也能为心肌提供有效的核心降温。它技术简单，能将心脏停搏液输送到心肌而无冠状动脉开口损伤的风险，并且可用于存在严重主动脉瓣关闭不全和主动脉根部开放的情况。因此，逆行冠状静脉窦灌注似乎是心脏手术期间一种有价值的心肌保护替代模式。
