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Production of a Collateral Circulation to the Heart

1935; SAGE Publishing; Volume: 32; Issue: 5 Linguagem: Inglês

10.3181/00379727-32-7850p

1535-3702

Claude S. Beck, Vladimír Tichý, Anton Moritz,

Vascular anomalies and interventions

The experiments recorded in this paper are to a large extent an outgrowth of work done previously., It was our purpose to destroy the normal coronary circulation and in its place provide an adequate collateral circulatory bed. This study, begun in February, 1932, is based upon 103 dogs in which attempts were made to produce a collateral circulation to the heart. The problem of producing a new blood supply to the heart resolved itself into 2 components, (1) to provide a vascular bed from which blood vessels could grow directly into the myocardium, (2) to reduce the circulation in the myocardium, so that collateral circulation in the adhesions might develop. The operative procedure was one of almost constant evolution. Omitting the details of development the procedure used was as follows:Epicardiectomy was done under ether anesthesia by abrasion and stripping with a special burr. The lining of the parietal pericardium was removed. Silver clips were placed around the major coronary arteries. The lumina of these vessels were reduced in stages at repeated operations over a period of 2 years in some of the animals.The collateral bed established through the pericardial adhesions was injected with a watery suspension of iron ferrocyanide (0.4%). The injection was carried out as follows: The venae cavae and azygos vein were ligated. The right auricle was incised. The aorta was clamped close to the heart and the aorta was incised between heart and clamp. This dissection prevented injection of the heart by way of the aortic coronary ostia and by way of the thebesian vessels. Dye was run into the right carotid artery under gravity pressure. The pressure in the arterial system, as determined from the left carotid artery, was between 100 and 120 mm. mercury.