title: Effect of pressure-controlled intermittent coronary sinus occlusion (PICSO) on myocardial ischaemia and reperfusion in a closed-chest porcine model.
abstract: OBJECTIVE
  To investigate a pressure-controlled intermittent coronary sinus occlusion (PICSO) system in an ischaemia/reperfusion model.
  
  
  RESULTS
  We randomly assigned 18 pigs subjected to 60 minutes ischaemia by left anterior descending (LAD) coronary artery balloon occlusion to PICSO (n=12, groups A and B) or to controls (n=6, group C). PICSO started 10 minutes before (group A), or 10 minutes after (group B) reperfusion and was maintained for 180 minutes. A continuous drop of distal LAD pressure was observed in group C. At 180 minutes of reperfusion, LAD diastolic pressure was significantly lower in group C compared to groups A and B (p=0.02). LAD mean pressure was significantly less than the systemic arterial mean pressure in group C (p=0.02), and the diastolic flow slope was flat, compared to groups A and B (p=0.03). IgG and IgM antibody deposition was significantly higher in ischaemic compared to non-ischaemic tissue in group C (p<0.05). Significantly more haemorrhagic lesions were seen in the ischaemic myocardium of group C, compared to groups A and B (p=0.002). The necrotic area differed non-significantly among groups.
  
  
  CONCLUSIONS
  PICSO was safe and effective in improving coronary perfusion pressure and reducing antibody deposition consistent with reduced microvascular obstruction and ischaemia/reperfusion injury.
authors.affiliation: Department of Cardiology, Bern University Hospital, Bern, Switzerland. ahmed.khattab@insel.ch
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Khattab
authors.forename: Stephan
authors.initials: S
authors.lastname: Stieger
authors.forename: Pranitha J
authors.initials: PJ
authors.lastname: Kamat
authors.forename: Stijn
authors.initials: S
authors.lastname: Vandenberghe
authors.forename: Anjan
authors.initials: A
authors.lastname: Bongoni
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
authors.forename: Otto M
authors.initials: OM
authors.lastname: Hess
authors.forename: Robert
authors.initials: R
authors.lastname: Rieben
mesh_terms: D000818:Animals; D062186:Arterial Pressure; D006328:Cardiac Catheterization / Q000295:instrumentation; D062906:Cardiac Catheters; D003326:Coronary Circulation; D054326:Coronary Sinus / Q000503:physiopathology*; D004195:Disease Models, Animal; D004867:Equipment Design; D007074:Immunoglobulin G / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D019157:Ischemic Preconditioning, Myocardial / Q000295:instrumentation / Q000379:methods*; D008833:Microcirculation; D009203:Myocardial Infarction / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D015428:Myocardial Reperfusion Injury / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D009206:Myocardium / Q000276:immunology / Q000473:pathology; D009336:Necrosis; D013552:Swine; D013997:Time Factors; D017725:Ventricular Pressure
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M