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Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
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Reduction of infarct size with coronary venous retroperfusion

H L Lazar1, C K Haan, X Yang

  • 1Department of Cardiothoracic Surgery, Boston University Medical Center, MA.

Circulation
|November 1, 1992
PubMed

Insights

Pressure-controlled intermittent coronary sinus occlusion (PICSO) and L-glutamate reduce heart damage during urgent revascularization surgery. This technique improves cardiac function and minimizes tissue injury after acute coronary occlusion.

Area of Science:

  • Cardiovascular Surgery
  • Ischemic Heart Disease
  • Myocardial Protection

Background:

  • Acute coronary occlusion during surgical revascularization can lead to significant ischemic damage.
  • Myocardial protection strategies are crucial to minimize tissue injury in these critical situations.

Purpose of the Study:

  • To evaluate the efficacy of coronary venous retroperfusion using pressure-controlled intermittent coronary sinus occlusion (PICSO).
  • To assess the combined effect of PICSO with L-glutamate substrate enhancement on reducing ischemic damage.

Main Methods:

  • A porcine model with surgical coronary occlusion was used.
  • Groups received PICSO alone, PICSO with oxygenated blood, PICSO with L-glutamate, or no intervention (unmodified).
  • Measurements included wall motion scores, necrosis-to-area of risk ratio, and tissue acidosis (pH).

Main Results:

  • PICSO alone and in combination with L-glutamate significantly improved wall motion scores compared to the unmodified group.
  • Both PICSO groups demonstrated a significantly lower area of necrosis-to-area of risk ratio.
  • Tissue acidosis was significantly reduced in hearts treated with PICSO and L-glutamate.

Conclusions:

  • Coronary venous retroperfusion with PICSO is effective in reducing ischemic damage.
  • Combining PICSO with L-glutamate further enhances myocardial protection during surgical revascularization.
  • These findings support PICSO as a valuable adjunct for myocardial preservation.
Abstract

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