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The Journal of Cardiovascular Surgery 2001 February;42(1):27-35

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

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


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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.

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