Pre-arterialization of coronary veins prior to retroperfusion of ischemic myocardium: percutaneous closure device.
Pre-arterialization of coronary veins prior to retroperfusion of ischemic myocardium: percutaneous closure device.
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DOI：
10.3389/fcvm.2023.1208903
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发表时间：
2023
影响因子：
3.6
通讯作者：
Kassab, Ghassan S.
中科院分区：
文献类型：
--
作者：
Choy, Jenny S.;Hubbard, Terry;Golts, Eugene M.;Bhatt, Deepak L.;Navia, Jose A.;Kassab, Ghassan S.
关键词：
由于冠状动脉静脉突然暴露于动脉压力下的水肿和出血，治疗心肌缺血的慢性冠状动脉反灌流以前失败过。这项研究的目的是在冠状静脉回流前选择性地使冠状静脉动脉化，以避免血管水肿和出血。在32只动物(I组 = 19和II组 = 13)中，采用无创闭塞模型阻断左前降支(LAD)动脉。I组于2周内用缝线结扎法(IA = 11组)或闭塞器(IB = 8组)阻断心脏大静脉，使静脉系统在中等压力(动静脉平面之间)下动脉化，然后经左乳内动脉(LIMA)吻合行冠状动脉搭桥术。II组：结扎左前降支，作为对照组。系列超声心动图显示，这种适应性动脉化方法使左心功能得到恢复，射血分数(EF)从冠脉闭塞后的38% ± 5%增加到CVBG后8周的53% ± 7%，而II组的EF从未恢复(41% ± 2%~33% ± 7%)。静脉系统的重塑不仅可以在CVBG实施时恢复心肌功能，而且可能促进了天然小动脉和新动脉化的小静脉之间的一种新的“侧支”形式，从而使缺血心肌重新血运。这些发现形成了静脉动脉化-血运重建术治疗顽固性心绞痛和使用混合经皮(动脉化闭合装置)/外科手术入路(CVBG)进行心肌血运重建术的潜在理论基础。
Chronic coronary retroperfusion to treat myocardial ischemia has previously failed due to edema and hemorrhage of coronary veins suddenly exposed to arterial pressures. The objective of this study was to selectively adapt the coronary veins to become arterialized prior to coronary venous retroperfusion to avoid vascular edema and hemorrhage. In 32 animals (Group I = 19 and Group II = 13), the left anterior descending (LAD) artery was occluded using an ameroid occlusion model. In Group I, the great cardiac vein was blocked with suture ligation (Group IA = 11) or with occlusion device (Group IB = 8) to arterialize the venous system within 2 weeks at intermediate pressure (between arterial and venous levels) before a coronary venous bypass graft (CVBG) was implemented through a left internal mammary artery (LIMA) anastomosis. Group II only received the LAD artery occlusion and served as control. Serial echocardiograms showed recovery of left ventricular (LV) function with this adaptation-arterialization approach, with an increase in ejection fraction (EF) in Group I from 38% ± 5% after coronary occlusion to 53% ± 7% eight weeks after CVBG, whereas in Group II the EF never recovered (41% ± 2%–33% ± 7%). The remodeling of the venous system not only allowed restoration of myocardial function when CVBG was implemented but possibly promoted a novel form of “collateralization” between the native arterioles and the newly arterialized venules, which revascularized the ischemic myocardium. These findings form a potential rationale for a venous arterialization-revascularization treatment for the refractory angina and the “no-option” patients using a hybrid percutaneous (closure device for arterialization)/surgical approach (CVBG) to revascularize the myocardium.
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DOI：
10.1152/ajpheart.2001.280.3.h1361
发表时间：
2001-03-01
影响因子：
4.8
作者：
Ido, A;Hasebe, N;Kikuchi, K
通讯作者：
Kikuchi, K
影响因子：
2.9
作者：
Choy, Jenny S;Luo, Tong;Huo, Yunlong;Wischgoll, Thomas;Schultz, Kyle;Teague, Shawn D;Sturek, Michael;Kassab, Ghassan S
通讯作者：
Kassab, Ghassan S
影响因子：
2.3
作者：
Sharma, Rahul;Tradewell, Michael;Henry, Timothy D.
通讯作者：
Henry, Timothy D.
影响因子：
9
作者：
HAMMOND, GL;DAVIES, AL;AUSTEN, WG
通讯作者：
AUSTEN, WG
影响因子：
37.8
作者：
OH, BH;VOLPINI, M;ROSS, J
通讯作者：
ROSS, J