Myocardial salvage by the use of reperfusion and intraaortic balloon pump: experimental study.
BACKGROUND
Thrombolytic therapy improves left ventricular ejection fraction and survival. The study was undertaken to evaluate the effects of intraaortic balloon pump used in conjunction with reperfusion in reducing infarct size.


METHODS
Twenty-two dogs were subjected to proximal left anterior descending coronary artery occlusion. In group 1 (n = 7) occlusion lasted for 6 hours. In group 2 (n = 6) 2 hours of occlusion was followed by reperfusion. In group 3 (n = 9) after 2 hours of occlusion the dogs were assisted with the intraaortic balloon pump throughout the 4 hours of reperfusion. At the end of 6 hours the infarcted myocardium of the left ventricle was determined and expressed as percentage of the myocardium at risk.


RESULTS
In group 1, the infarcted myocardium was 79.3 +/- 9.9% of the myocardium at risk, in group 2, 59.0 +/- 19.9% (p < 0.05 versus group 1), and in group 3, 37.1 +/- 16.7% (p < 0.001 versus group 1 and p < 0.05 versus group 2). Endocardial viability ratio was increased by the intraaortic balloon pump; in group 1 it was 1.02 +/- 0.14, in group 2, 1.25 +/- 0.24, and in group 3, 1.47 +/- 0.31 (p < 0.001 versus group 1 and p < 0.02 versus group 2).


CONCLUSIONS
Reperfusion and intraaortic balloon pump increased salvage of the ischemic myocardium over that achieved by reperfusion alone in a canine occlusion-reperfusion model.
Nanas
J N
JN
Department of Clinical Therapeutics, University of Athens School of Medicine, Greece.
Nanas
S N
SN
Kontoyannis
D A
DA
Moussoutzani
K S
KS
Hatzigeorgiou
J P
JP
Heras
P B
PB
Makaritsis
K P
KP
Agapitos
E B
EB
Moulopoulos
S D
SD
D000704:Analysis of Variance; D000818:Animals; D004285:Dogs; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006439:Hemodynamics / Q000187:drug effects; D007423:Intra-Aortic Balloon Pumping; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000473:pathology; D009929:Organ Size; D011897:Random Allocation; D013300:Streptokinase / Q000008:administration & dosage
D005343:Fibrinolytic Agents; D013300:Streptokinase