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ABSTRACT 20
VENTRICULO-CORONARY PERFUSION: ARE THE BLINDERS
OFF?
Robert Emery, Cardiac Surgical Associates1 Eric Solien1,2
Frazier Eales, Minnesota Thoracic Associates 1 Clifford
Van Meter, Ochsner Clinic3, Katherine Tweden1,2
1Minneapolis, MN 2HeartStent Corporation
3 New Orleans, LA
Background: Conventional myocardial revascularization
involves dilating coronary lesions or redirecting vascular supply
from a supravalvular source. We investigated feasibility
of ventriculo-coronary artery bypass with a new device.
Methods: An L-shaped titanium tube with porous tip
was implanted in 8 juvenile domestic pigs in a beating heart procedure
to create a permanent left ventricle to LAD bypass. Patency
was assessed in 7 pigs at 2 and 4 weeks explant (one non-device
related death).
Results: Forward flow occurred exclusively during
systole. Net forward flow of 16 ml/min (n=8) was measured
using an ultrasonic probe. Patency was 100% (n=3)
at 2 weeks and 75% (n=4) at 4 weeks. Patent device histology
showed minimal reaction of artery to device with little to no
intimal proliferation and preservation of arterial structure.
Scanning electron microscopy (SEM) of patent devices showed minimal
platelet deposition. Coronary/device interface SEM showed
mature, non-thrombogenic covering with cuboidal cells.
Conclusion: Preliminary studies show promise of
perfusing ischemic myocardium with systolic flow. Additional
studies are warranted.
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