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THE JOURNAL OF CARDIOVASCULAR SURGERY
A Journal on Cardiac, Vascular and Thoracic Surgery
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
ORIGINAL ARTICLES CARDIAC PAPERS
The Journal of Cardiovascular Surgery 2001 February;42(1):27-35
Limitation of infarct size by fixed coronary arterial stenosis maintained during reperfusion
Nanas J. N., Nanas S. N., Kontoyannis D. A., Moussoutzani K. S., Rapti A. C., Charitos C. E., Terrovitis J. V., Stamatelopoulos S. F., Moulopoulos S. D.
From the Department of Clinical Therapeutics University of Athens School of Medicine Athens, Greece
Background. The effect on infarct size of a pre-infarction high-grade, fixed coronary arterial stenosis maintained during reperfusion, was evaluated.
Methods. This experimental study was carried out in the research laboratory of a University Hospital. A canine occlusion-reperfusion model was used. Twenty-eight dogs underwent proximal left anterior descending (LAD) coronary artery occlusion (O). In Group 1 (n=6) the O lasted for 6 hours. In Group 2 (n=6) the O lasted for 2 hours followed by 4 hours of reperfusion (R). In Group 3 (n=3), LAD was stenosed for 30 minutes followed by O for 6 hours. In Group 4 (n=7) LAD was stenosed for 30 minutes followed by O for 2 hours and then 4 hours of R during which the artery was kept stenosed at the same degree (fixed) as the initial one. In Group 5 (n=6) the protocol was identical to Group 4 with the additional use of the intra-aortic balloon pump during R.
Results. The infarcted myocardium was almost the same in Groups 1 and 3 (80.0±10.6% vs 77.3±3.8%, respectively, p=NS), but less in Group 2 (59.0±19.9%, p=0.046 vs Group 1). There were no hemodynamic differences between Groups 4 and 5 and the infarcted myocardium was almost identical in both groups (37.7±18.8% and 38.7±19.1%, respectively, p=NS). The combined results of Groups 4 and 5, regarding the infarcted myocardium, was 38.1±18% (p=0.037 vs Group 2).
Conclusions. In this acute coronary occlusion model, a pre-existing high-grade stenosis that maintained during reperfusion increased the amount of salvaged ischemic myocardium.