LV-powered coronary sinus retroperfusion reduces infarct size in acutely ischemic pigs

Background. We developed a prosthetic left ventricle (LV) to coronary sinus (CS) shunt (LVCSS) that is autoregulating and provides LV-powered retrogra de perfusion of the coronary sinus. Methods. Each of 20 Yorkshire pigs underwent 1 hour of left anterior descen ding diagonal artery occlusion followed by 3 hours of reperfusion. The cont rols (n = 5) did not have shunt treatment. The LVCSS group (n = 9) underwen t shunt treatment during the ischemic period. The LVCSS with partial corona ry sinus occlusion (PCSO) group (LVCSS+PCSO, n = 6) underwent shunt treatme nt and PCSO during the ischemic period. Vital staining and planimetry techn iques were used to determine the area at risk for infarction and the area o f necrosis. Results. The area at risk was not significantly different among groups. The area of necrosis was decreased by 53% in the LVCSS group and by 73% in the LVCSS+PCSO group when compared to controls (p < 0.01 among all groups). Conclusions. The LVCSS reduces infarct size in pigs after acute coronary ar tery occlusion. The addition of PCSO to LVCSS further improves myocardial s alvage. (C) 2000 by The Society of Thoracic Surgeons.