Katircioğlu S F, Yücel D, Saritas Z, Yamak B, Elsheikh A E, Köse K
Cardiovascular Surgery Department, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.
Thorac Cardiovasc Surg. 1998 Feb;46(1):1-6. doi: 10.1055/s-2007-1010175.
It is known that coronary venous retroperfusion restores the blood flow to the ischemic myocardium, resulting in reduction of infarct size and improvement in left-ventricular pump function. In this study, we used an animal model to investigate the effects of a simplified coronary venous retroperfusion system on myocardial hemodynamics. Twenty dogs were entered in this study. All dogs underwent fifteen minutes occlusion of the left anterior descending artery. For the rest of the experiment the dogs were randomized into two groups: the control group (n = 10) underwent a further 2 hours left anterior descending artery occlusion, then clamps were released and the animals were observed for 6 hours. In the retroperfusion group (n = 10) a simple aortocoronary sinus connection was made and retrograde perfusion achieved with an outflow of 43 +/- 6 ml/min. Retrograde coronary sinus perfusion was maintained for three hours and then the dogs were observed for six hours. Tissue adenosine triphosphate levels were 6 +/- 3 mumol/g in the control group and 12 +/- 2 mumol/g in the retroperfusion group (p < 0.05) 6 hours after reperfusion. Creatine phosphokinase levels were 99 +/- 11 IU/L in the control group and 42 +/- 8 IU/L in the retroperfusion group 6 hours after reperfusion (p < 0.05). Cardiac index was 63 +/- 4 ml/kg/min in the control group and 79 +/- 2 ml/kg/min in the retroperfusion group 6 hours after retroperfusion (p < 0.05). Left-ventricular stroke-work index at a pulmonary capillary artery wedge pressure of 20 mmHg was 0.54 +/- 0.06 g.m/kg in the retroperfusion group and 0.29 +/- 0.03 g.m/kg in the control group 6 hours after reperfusion (p < 0.05). It is concluded that myocardial hemodynamic and biochemical function can be preserved by simplified coronary sinus retroperfusion.
已知冠状静脉逆向灌注可恢复缺血心肌的血流，从而缩小梗死面积并改善左心室泵功能。在本研究中，我们使用动物模型来研究简化冠状静脉逆向灌注系统对心肌血流动力学的影响。20只狗进入本研究。所有狗均接受左前降支动脉15分钟的闭塞。在实验的其余时间，将狗随机分为两组：对照组（n = 10）再进行2小时的左前降支动脉闭塞，然后松开夹子并观察动物6小时。在逆向灌注组（n = 10）中，建立了简单的主动脉 - 冠状窦连接，并以43±6 ml/分钟的流出量实现逆向灌注。逆行冠状窦灌注维持3小时，然后观察狗6小时。再灌注6小时后，对照组组织三磷酸腺苷水平为6±3 μmol/g，逆向灌注组为12±2 μmol/g（p < 0.05）。再灌注6小时后，对照组肌酸磷酸激酶水平为99±11 IU/L，逆向灌注组为42±8 IU/L（p < 0.05）。逆向灌注6小时后，对照组心脏指数为63±4 ml/kg/分钟，逆向灌注组为79±2 ml/kg/分钟（p < 0.05）。再灌注6小时后，在肺毛细血管楔压为20 mmHg时，逆向灌注组左心室每搏功指数为0.54±0.06 g.m/kg，对照组为0.29±0.03 g.m/kg（p < 0.05）。结论是，简化冠状窦逆向灌注可保留心肌血流动力学和生化功能。
