Improved myocardial protection by antegrade perfusion in combination with coronary sinus occlusion in the presence of left anterior descending artery obstruction.

The present study was undertaken to evaluate the improved protection of antegrade aortic root perfusion combined with intermittent coronary sinus occlusion (APCSO) for the 1-hour ischemic myocardium in the presence of left anterior descending artery occlusion, 12 dogs were divided into 2 groups: anteperfusion (AP) alone (n = 6) and APCSO (n = 6). The experimental results showed that APCSO provided a better cardioplegic distribution and a lower hypothermia (15.6 degrees C versus 17.2 degrees C) in the occluded LAD region, compared with AP. After ischemia, cardiac index and left ventricular stroke index recovered excellently in APCSO (128% to 141% and 115% to 158% of preischemic values, respectively), and much worse in AP (69% to 82% and 53% to 73% of preischemic values, respectively). Our study has confirmed that APCSO is superior to AP in myocardial protection in the presence of coronary artery occlusion.