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Catheter‐based ventricle‐coronary vein bypass
Author(s) -
Hayase Motoya,
Kawase Yoshiaki,
Yoneyama Ryuichi,
Hoshino Kozo,
McGregor Jennifer,
MacNeill Briain D.,
Lowe Harry C.,
Burkhoff Daniel,
Boekstegers Peter,
Hajjar Roger J.
Publication year - 2005
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20312
Subject(s) - medicine , cardiology , great cardiac vein , ventricle , implant , coronary vein , catheter , artery , occlusion , perfusion , radiology , surgery , coronary sinus
The goal of this study was to investigate the feasibility of a catheter‐based ventricle‐to‐coronary vein bypass (VPASS) in order to achieve retrograde myocardial perfusion by a conduit (VSTENT) from the left ventricle (LV) to the anterior interventricular vein (AIV). Percutaneous coronary venous arterialization has been proposed as a potential treatment strategy for otherwise untreatable coronary artery disease. In an acute setting, the VSTENT implant was deployed percutaneously using the VPASS procedure in five swine. Coronary venous flow and pressure patterns were measured before and after VSTENT implant deployment with and without AIV and left anterior descending artery (LAD) occlusion. In a separate chronic pilot study, the VPASS procedure was completed on two animals that had a mid‐LAD occlusion or LAD stenosis. At day 30 post‐VPASS procedure, left ventriculography and magnetic resonance imaging (MRI) were performed to assess the patency and myocardial viability of the VSTENT implants. Pre‐VSTENT implantation, the mid‐AIV systolic wedge pressure was significantly lower than LV systolic pressure during AIV blockage (46 ± 19 vs. 90 ± 16 mm Hg; P < 0.01). The VSTENT implant deployment was performed without complication and achieved equalization of the AIV and LV systolic pressures and creation of retrograde flow in the distal AIV (maximal flow velocity: 37 ± 7 cm/sec). At day 30 post‐VPASS procedure, left ventriculography showed VSTENT implant patency. MRI perfusion images demonstrated myocardial viability even with an LAD occlusion. Coronary retrograde perfusion using the VPASS procedure is feasible and may represent a potential technique for end‐stage myocardial ischemia. Catheter Cardiovasc Interv 2005. © 2005 Wiley‐Liss, Inc.