Demonstrates the dynamic nature of coronary collateral circulation in preserving myocardium during sequential occlusions of different coronary arteries.
Case of preserved myocardium via dynamic bidirectional collaterals; leaves open whether therapeutic collateral enhancement is feasible.
In 1980, a 46-year-old man suffered occlusion of his left anterior descending coronary artery with preservation of myocardium due to collateral flow from a patent right coronary artery. Six years later, unstable angina recurred, this time due to right coronary occlusion but with myocardial preservation due to reversal of collateral flow from his now recanalized left anterior descending artery.
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Thomas et al. (1986) studied this question.
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