Coronary Sinus Intervention in Cardiac Surgery, Second Edition

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ISBN: 9781587060069 | 158706006X
Cover: Hardcover
Copyright: 10/1/2000

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(Eurekah.com) Univ. of Vienna, Austria. Topics include basic considerations and techniques, venous drainage of the myocardium, structure and function of the cardiac lymphatic system, coronary sinus interventions in experimental research, and more. DNLM: Heart Arrest, Induced.

Basic Considerations and Techniques in Coronary Sinus Interventions	p. 1
Introduction	p. 1
Surgical Coronary Sinus Interventions for Myocardial Protection	p. 2
Coronary Sinus Techniques in Interventional Cardiology	p. 8
Addendum: Update in Surgical Coronary Sinus Intervention	p. 10
Introduction	p. 10
Delivery of Nutritive Substrates and Wash-Out of Metabolites	p. 11
Inflammatory Response in Cardiac Surgery	p. 12
Inflammatory Response and Coronary Sinus Intervention	p. 13
Summary	p. 14
The Venous Drainage of the Myocardium in the Human Heart	p. 18
Introduction	p. 18
Material and Methods	p. 18
The Coronary Sinus	p. 19
The Cardiac Veins	p. 25
The Anatomical Basis of Coronary Sinus Reperfusion	p. 35
Introduction	p. 35
Material and Methods	p. 38
Results and Discussion	p. 39
Structure and Function of the Cardiac Lymphatic System	p. 55
The Anatomy of the Cardiac Lymphatic System	p. 55
Formation of Lymph	p. 57
The Cardiac Lymph	p. 61
The Composition of Cardiac Lymph	p. 63
Effects of Imbalanced Formation and Drainage of Cardiac Lymph	p. 63
Regional Differences and Variability in Left Ventricular Wall Motion	p. 70
Introduction	p. 70
Local Differences in Left Ventricular Wall Motion	p. 70
Variability in Ventricular Wall Motion Pattern	p. 73
Functional State of the Myocardium and Oxygen Delivery: Rules and Exceptions	p. 75
Conclusion	p. 78
Computer Simulation and Modeling of the Coronary Circulation	p. 81
Computer Simulation in Coronary Physiology	p. 81
Models of the Coronary Circulation	p. 81
Hemodynamic Simulations	p. 82
Simulation Studies in Coronary Surgery	p. 85
The Hazards of Ischemia/Reperfusion Injury During Revascularization Procedures in Acute Myocardial Ischemia	p. 88
Myocardial Ischemia/Reperfusion Injury	p. 88
The Possible Role of Coronary Vein Retroperfusion in the Prevention of Ischemia/Reperfusion Injury During Cardiogenic Shock and Acute Coronary Revascularization Procedures	p. 90
Distribution of Antegrade and Retrograde Cardioplegia-Experimental Results	p. 97
Introduction	p. 97
Composition	p. 97
Studies of Regional Blood Flow Distribution in the Beating Heart	p. 100
Experimental Hypotheses	p. 102
Studies of Regional Cardioplegia Flow Distributions	p. 102
Flow	p. 104
Inhomogeneity	p. 104
Correlation	p. 104
Other Studies	p. 106
Discussion	p. 108
The Selection of Antegrade Versus Retrograde Cardioplegia Delivery	p. 112
Introduction	p. 112
Previous Studies of Retrograde Microvascular Perfusion	p. 112
Nutritive Perfusion: Antegrade vs. Retrograde Cardioplegia	p. 114
Anatomic Basis for Physiologic Differences between Antegrade and Retrograde Cardioplegia	p. 114
Myocardial Cooling: Antegrade vs. Retrograde Cardioplegia	p. 115
Assessment of Cardioplegia Flow Using Myocardial Contrast Echocardiography	p. 115
Summary	p. 116
Retrograde Cardioplegia in Infants and Children	p. 120
Introduction	p. 120
The Case for Retrograde Cardioplegia in Infants and Children	p. 120
Technique	p. 121
Future Applications	p. 122
Conclusions	p. 122
Coronary Sinus Interventions During Surgical Treatment of Acute Myocardial Infarction	p. 123
Introduction	p. 123
Pathophysiology of Acute Myocardial Infarction	p. 124
Importance for Using Retrograde Techniques During Surgical Treatment for Acute Myocardial Infarction	p. 127
Surgical Technique	p. 129
Conclusions	p. 134
Coronary Venous Interventions (Experimental Clinical Studies)	p. 140
Introduction	p. 140
SRP Evolution and Experimental Studies	p. 141
Clinical Safety, Logistics and Effectiveness of SRP and ICSO	p. 154
Modified SRP or Alternate Retrograde Interventions	p. 159
Coronary Venous Retroinfusion	p. 161
Addendum: Coronary Venous Interventions: Update of Recent Developments	p. 171
SRP Support During PTCA Balloon Inflations	p. 172
Extended SRP Treatment of Critically Jeopardized Myocardium	p. 173
SRP in Conjunction with IABP	p. 173
Elucidation and Enhancement of SRP Effectiveness	p. 174
Recent Investigations Involving ICSO or PICSO	p. 175
Alternate Coronary Vein Support Concepts	p. 175
Concluding Remarks	p. 176
Coronary Sinus Interventions in Experimental Research: A Review	p. 179
Introduction	p. 179
Experimental Models and Techniques	p. 180
Effects of PICSO During Reperfusion	p. 182
Effects of PICSO During Cardioplegic Arrest	p. 182
Effects of PICSO and Retroperfusion Immediately Following Coronary Occlusion	p. 189
Substrate Enhanced Coronary Venous Retroperfusion	p. 191
Retroperfusion and Intraaortic Balloon Pump (IABP) Support	p. 192
Conclusions and Clinical Applications	p. 194
Coronary Venous Retroinfusion During Interventional Cardiology	p. 199
Introduction	p. 199
Different Concepts of Coronary Venous Retroinfusion	p. 200
Comparison of the Efficacy of PICSO, SRP and SSR in Experimental Models	p. 202
Clinical Results Using Synchronized Retroperfusion (SRP) in Comparison to Other Support Devices	p. 204
Potential Clinical Applications and Future Perspectives for Retroinfusion Support in Interventional Cardiology	p. 205
Summary	p. 210
Addendum: New Developments in Coronary Venous Retroinfusion Support During Interventional Cardiology	p. 213
Introduction	p. 213
The Concept of Selective Suction and Pressure-Regulated Retroinfusion	p. 214
Clinical Efficacy and Feasibility of Selective Suction and Pressure-Regulated Retroinfusion	p. 217
Index	p. 222
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Coronary Sinus Intervention in Cardiac Surgery, Second Edition

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