TY - JOUR
AR - JICOA-2019-2-107
TI - Evidences for Inotropism Triggered by Simultaneous Antegrade And Retrograde Myocardial Perfusion in A Swine Model
AU - Antoine, Chalon
AU - Juan-Pablo, Maureira
AU - Aude, Falanga
AU - Brice, Mourer
AU - Daniel, Grandmougin
AU - Fréderique, Groubatch-Joineau
AU - Nguyen, Tran
AU - Patrick, Lacolley
AU - Pierre-Yves, Marie
AU - Vanessa, Marie
JO - Journal of Integrative Cardiology Open Access
PY - 2019
DA - Tue 30, Jul 2019
SN - 2674-2489
DO - http://dx.doi.org/10.31487/j.JICOA.2019.02.07
UR - https://www.sciencerepository.org/evidences-for-inotropism-triggered-by-simultaneous-antegrade-and-retrograde-myocardial-perfusion-in-a-swine-model_JICOA-2019-2-107 
KW - Self Myocardial Retroperfusion (SMR), coronary Circulation, left azygos vein, inotropism, hemodynamics, conductance catheter
AB - Objectives: Retrograde perfusion into the coronary sinus is currently used to deliver cardioplegia. We
developed an in-vivo porcine beating-heart model of self-myocardial retroperfusion (SMR) using the venous
route to increase myocardial oxygenation of the left ventricle. Then, we sought to assess whether the
association of a simultaneous antegrade and retrograde myocardial perfusion with oxygenated blood might
trigger hemodynamic and cardiac responses compared with a single antegrade myocardial supply.
Methods: A group of 8 pigs was dedicated to undergo SMR with a simultaneous antegrade physiological
LAD perfusion. SMR was achieved with a bypass-line between the ascending aorta and the coronary sinus
to perform a selective retrograde perfusion of the great cardiac vein with oxygenated blood after ligation of
the left azygos vein.
Cardiac output (CO), maximal pressure in the LV (Pmax in-LV), stroke volume (SV), left ventricular
ejection fraction (LVEF), diastolic durations, heart rate (HR), and arterial systemic pressure were monitored
with conductance catheters. These data were collected during the antegrade myocardial perfusion (baseline
period) and compared with data recorded during a simultaneous antegrade and retrograde perfusion. At the
end of the procedures, the hearts were harvested for histology.
Results: SMR with antegrade LAD perfusion showed inotropic properties with significant improvements
in CO, SV, Pmax in-LV and LVEF (p<0.0001) compared with baseline values. Histology confirmed no
signs of tissular injuries.
Conclusions: The selective retrograde perfusion of the great cardiac vein with oxygenated blood combined
with an antegrade physiological LAD perfusion showed obvious capacities to trigger inotropic properties
opening interesting perspectives.