The Physiologic Explanation of the Changes in the Coronary Circulation Following Prolonged Aortico-Coronary Sinus Anastomosis 1

This is a report of the physiologic changes in the coronary circulation which are precipitated by prolonged periods of arterialization of the coronary sinus. Initial experiments pertaining to the physiology of the coronary circulation of dogs in which the coronary sinus had been arterialized for four to eight weeks demonstrated a protection to the heart against ventricular fibrillation, following sudden occlusion of the circumflex branch of the left coro-nary artery. In this group of animals, the myo-cardium was perfused in retrograde fashion with extraction of oxygen from the blood flowing back-ward, and the intercoronary collateral flow was increased (1-3). Subsequently, two series of animals were stud-ied six and twelve months respectively after ar-terialization of the coronary sinus, to determine whether the retroperfusion of the myocardium, and the protection to the heart against ventricular fibrillation persisted. METHODS Two groups of animals, whose weights varied be-tween 15 and 18 kg., were first prepared using the two stage operation developed by Beck (4). At a first stage, through a left-sided approach, an external jugular vein graft was placed between the aorta and the coronary sinus. Approximately one month later, using a right-sided approach, the coronary sinus was partially ligated over a probe to 2 to 3 mm. The first group, Group A, led a normal kennel existence for six months prior to obtaining physiologic data. In the second group, Group B, physiologic data were obtained after twelve months. I This work was supported by the Mary Bailey Foun-dation. 2This study was carried out during the tenure of a