The efficacy of diastolic balloon pulsation in coronary sinus on myocardial metabolism and haemodynamics

Abstract

The effect of diastolic coronary sinus balloon pulsation on acute myocardial ischemia and infarction was evaluated. A device for this purpose was developed that consisted of a balloon catheter and pump system, the produced controlled, intermittant diastolic pulsation in coronary sinus. It was hypotesized that; facilitate improved retrograde flow to ischemic areas and allow for more complete oxygen exchange and venous washout of metabolits, with elevated coronary sinus pressure and retrograde pulsation. For this purpose; the experimental study was done on 10 dogs. First stage; Coronary Sinus Diastolic Ballon Pulsation (CSDBP) was performed on normally myocardium, at beat to beat 1:1, 2:1, and 3:1 cardiac cycle. Any haemodynamics deteriotions were showed. Then, coronary perfusion deteriotions were performed by coronary artery ligation. In this stage; mean EKG-ST segment level elevated to 6.3 ± 0.95 mm (p < 0.01) and coronary sinus blood lactate level increased to 48.4 ± 3.4 mg/dl from 17.62 ± 2.86 mg/dl (p < 0.01). EKG-ST segment level decreased to 3.73 ± 0.64 mm and coronary sinus blood lactate level decreased to 43.12 ± 2.55 mg/dl (p < 0.05) with 1:1 beat to beat CSDBP. EKG-ST segment level decreased to 2.95 ± 0.73 mm and CS blood lactate level decreased to 39.65 ± 1.98 mg/dl with 2:1 beat to beat CSDBP. EKG-ST segment level decreased to 3.6±0.42 mm and CS blood lactate level decreased to 37.57 ± 1.98 mg/dl with 3:1 beat to beat CSDBP too. We hypotesized that, this CSDBP technique is effective; in temporary palliative treatment of acute myocardial ischemia and infarction.