Selective regional myocardial infiltration by the percutaneous coronary venous route: A novel technique for local drug delivery

Recent advances in the treatment of heart disease, in particular cardiovasc ular gene therapy and therapeutic angiogenesis, highlight the need for effi cient and practical local delivery methods for the heart. We assessed the f easibility of percutaneous selective coronary venous cannulation and inject ion as a novel approach to local myocardial drug delivery. In anesthetized swine, the coronary sinus was cannulated percutaneously and a balloon-tippe d catheter advanced to the anterior interventricular vein (AIV) or middle c ardiac vein (MCV). During balloon occlusion, venous injection of radiograph ic contrast caused regional infiltration of targeted myocardial regions. Co mplete AIV occlusion had no impact on LAD flow parameters. Videodensitometr ic analysis following venous injection showed that radiographic contrast pe rsisted for at least 30 min. Selective regional myocardial infiltration is feasible by this approach, targeting selected myocardial beds, including th e apex, anterior wall, septum, and inferoposterior wall. This novel techniq ue has potential application for local myocardial drug or growth factor del ivery. Cathet. Cardiovasc. Intervent. 51:358-363, 2000. (C) 2000 Wiley-Liss , Inc.