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Noncoronary collateral myocardial blood flow.

J Brazier, C Hottenrott, G Buckberg

    The Annals of Thoracic Surgery
    |April 1, 1975
    PubMed
    Summary
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    Noncoronary collateral flow is present in normal hearts with chronic coronary occlusion and left ventricular hypertrophy. This flow is highest during cardiac arrest, indicating the arrested heart may not be anoxic.

    Area of Science:

    • Cardiovascular Physiology
    • Cardiac Metabolism
    • Coronary Circulation

    Background:

    • Chronic coronary occlusion can lead to reduced blood flow to the heart muscle.
    • Left ventricular hypertrophy (LVH) increases the heart's workload and oxygen demand.
    • Understanding collateral circulation is crucial for managing ischemic heart disease.

    Purpose of the Study:

    • To investigate the presence and characteristics of noncoronary collateral flow in normal hearts.
    • To determine how factors like cardiac arrest, perfusion pressure, and blood viscosity affect this flow.
    • To assess the potential for myocardial oxygenation in arrested hearts.

    Main Methods:

    • Utilized a canine model with induced chronic coronary occlusion and/or left ventricular hypertrophy.

    Related Experiment Videos

  • Measured luminal-left ventricular flow under various conditions: cardiac arrest (aortic cross-clamping), reduced perfusion pressure (50 mm Hg), and hemodilution.
  • Quantified collateral flow in milliliters per 100 grams per minute (ml/100 gm/min).

    • Main Results:

    • Demonstrated variable amounts of noncoronary collateral flow (0.2 to 16 ml/100 gm/min) in normal hearts.
    • Observed peak flow during aortic cross-clamping (cardiac arrest).
    • Noted a significant decrease in flow at lowered perfusion pressure and a slight increase with reduced blood viscosity.

    Conclusions:

    • Noncoronary collateral pathways provide a significant blood supply to the heart, even in the absence of coronary occlusion.
    • Cardiac arrest via aortic cross-clamping does not necessarily result in myocardial anoxia due to collateral flow.
    • These findings have implications for understanding myocardial protection during cardiac surgery and in ischemic conditions.