Retrograde coronary capillary perfusion for prevention and reversal of cardiogenic shock in experimental myocardial infarction.
The coronary sinus and coronary veins offer an access route for delivery of increased oxygen to ischemic myocardium surrounding the central dead zone of heart muscle in cardiogenic shock due to myocardial infarction. This investigation was conducted to determine if transvenous retrograde coronary capillary perfusion with oxygenated blood would prevent and reverse cardiogenic shock in experimental myocardial infarction produced by acute ligation of the circumflex and anterior descending left coronary artery in dogs. Cardiac output and systemic blood pressure were maintained near control values for up to 30 minutes when total left coronary ligation was accompanied by coronary retroperfusion. Conversely, both cariac output and systemic blood pressure fell to severe cardiogenic shocks levels within 2 minutes of total left cardiogenic shock levels within 2 minutes of total left coronary artery occlusion without retrograde flow or when retrograde flow was terminated 5 to 30 minutes following simultaneous coronary ligation and institution of retrograde flow.
D000818:Animals; D001011:Aorta; D001794:Blood Pressure; D002196:Capillaries; D002302:Cardiac Output; D003326:Coronary Circulation; D004285:Dogs; D005112:Extracorporeal Circulation / Q000379:methods*; D008026:Ligation; D009203:Myocardial Infarction / Q000150:complications*; D012770:Shock, Cardiogenic / Q000517:prevention & control* / Q000628:therapy; D014693:Ventricular Fibrillation / Q000628:therapy