New catheter-pump system for diastolic synchronized coronary sinus retroperfusion.

Coronary retroperfusion with the object of delivering oxygenated blood to the ischemic myocardium might be defined as the process of withdrawing blood from a systemic artery and reinjecting it into the coronary sinus. A diastolic synchronized retroperfusion catheter-pump system is presented and feasibility of achieving retrograde infusion of arterial blood was tested. An autoinflatable bladder catheter was specially designed to compartmentalize the coronary sinus at onset of diastole and insure unidirectional retrograde infusion of arterial blood. Bladder deflation at onset of systole allowed coronary venous drainage. Actuation of the retroperfusion bladder catheter was obtained from an electropneumatic console triggered by the electrocardiogram. In vitro and animal studies indicate that this system converted the natural (steady) arteriovenous shunt flow into an artificially pulsed shunt flow, with maximal positive flow in diastole and trivial negative flow in systole but did not alter absolute magnitude of shunt flow. Thus, diastolic synchronized retroperfusion of arterial blood through the coronary sinus may provide temporary protection from acute myocardial ischemia.