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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2001 October;42(5):611-4

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Right vagal nerve stimulation for coronary anastomosis without cardiopulmonary bypass. Investigation in dogs

Hayashi I., Yamamoto T., Hosoda Y.

From the Department of Thoracic and Cardiovascular Surgery, Juntedo University, Tokyo, Japan


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Back­ground. The pur­pose of ­this ­study is to ­assess the poten­tial of ­right ­vagal ­nerve stim­u­la­tion for ­reducing the ­heart ­rate ­during cor­o­nary anas­tom­osis ­without car­di­o­pul­mo­nary ­bypass.
­Methods. ­Through the ­fourth ­left inter­costal ­space, ­left ­internal tho­racic ­artery ­grafts ­were ­sutured to the ­left ante­rior ­descending ­artery ­with the ­heart ­beating. In ­Group I (n=7), two ­dogs under­went ­right cer­vical ­vagal stim­u­la­tion ­alone and ­five ­dogs under­went ­right cer­vical ­vagal stim­u­la­tion ­during intra­ve­nous infu­sion of dil­tiazem or verap­amil. In ­Group II (n=3), one dog under­went ­right tho­racic ­vagal stim­u­la­tion ­alone and two ­dogs under­went ­right tho­racic ­vagal stim­u­la­tion ­during intra­ve­nous infu­sion of dil­tiazem or verap­amil. The tho­racic ­vagal ­nerve was iso­lated endo­scop­i­cally. The elec­tro­car­di­o­gram and ­aortic pres­sure ­were mon­i­tored ­during inter­ven­tions.
­Results. In ­Group I, cer­vical ­vagal stim­u­la­tion ­reduced the ­heart ­rate ­from 190 to 45 and 180 to 42 b/min. ­During intra­ve­nous infu­sion of dil­tiazem or verap­amil, cer­vical ­vagal stim­u­la­tion ­caused ven­tric­ular ­arrest. In ­Group II, tho­racic ­vagal stim­u­la­tion ­decreased the ­heart ­rate ­from 205 to 70 ­b/min, and stim­u­la­tion ­during intra­ve­nous infu­sion of dil­tiazem ­caused ven­tric­ular ­arrest.
Con­clu­sions. ­Right ­vagal stim­u­la­tion ­during intra­ve­nous infu­sion of dil­tiazem or verap­amil has poten­tial ­value as a tech­nique for ­reducing the ­heart ­rate ­during cor­o­nary anas­tom­osis ­without car­di­o­pul­mo­nary ­bypass.

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