CSI — A New Approach to Interventional Cardiology by W. Mohl, D. Faxon, E. Wolner

By W. Mohl, D. Faxon, E. Wolner

Editorial.- file of the foreign operating team on coronary sinus interventions.- The so-called “silent area” of the coronary sinus.- influx, outflow and pressures within the coronary circulation.- Coronary sinus interventions: medical application.- The promise and barriers of coronary venous retroperfusion: classes from the prior and new directions.- Synchronized coronary sinus retroperfusion present medical perspective.- PICSO prestige record 1985.- Retrograde cardioplegia: myocardial safeguard through the coronary veins — 1986.- Technological features of coronary sinus interventions.- professionals and cons — coronary sinus intervention vs. traditional therapy.- CSI: transitority help or long term remedy.

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Extra info for CSI — A New Approach to Interventional Cardiology

Example text

Coronary venous physiology and effects of manipulations; III. Recent development of an intermittent coronary sinus occlusion technique; IV. Past and renewed surgical retroperfusion methods; and V. Development of clinically oriented retroperfusion techniques. I. Coronary venous anatomy and drainage patterns As early as 1708, Thebesius (115) injected dye into coronary veins and studied their drainage, some of which enters the cardiac chambers. Studies of the Thebesian circulation were pursued by Abernathy (I) in 1798, Langer (72) in 1880, and Pratt (95) in 1898.

Current clinical studies will probably document a role for PICSO in the reperfusion period during cardiac surgery. As with any new therapy, the coronary sinus interventions will of necessity be as good as or better than current medical and or surgical therapy. Towards this end, the coronary sinus techniques will require evaluation against standard therapy or in combination with accepted treatments. In addition, the advantages and disadvantage of each technique must be weighed individually and compared to each other.

There was also no evidence of excess myocardial edema in either the jeopardized ischemic or normally perfused zones. Significant red cell hemolysis or platelet destruction did not occur. Therefore, the authors concluded that SRP is a safe and effective treatment of acute myocardial infarction in experimental animals and warrants clinical testing. In the early 1980s Mohl first described the technique of pressure controlled intermittent coronary sinus occlusion (PICSO). With his colleagues he reported the effects of PICSO during experimental myocardial infarction (28).

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