Studies were made on dogs at various times up to one year following the coronary sinus anastomosis of Beck to determine the chronic effects of the operation. The results indicate that the graft perfuses the capillary bed of the occluded circumflex artery for about five weeks after the operation and then loses its functional contact with the capillary bed probably because of obliterative venous changes. However, as a result of an anoxia, there is definite development of intercoronary collateral vessels during the first few weeks, which persist throughout the year even though there is no arterial occlusion. It is concluded that in dogs the Beck operation is protective against the major effects of coronary ligation because of retrograde capillary flow early and intercoronary anastomoses later.
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The mortality rates were determined in two groups of dogs following acute circumflex artery occlusion. Both groups were surgically prepared in the same manner. In a group of 20 dogs the corollary sinus was cannulated to divert the blood into the left jugular vein. Circumflex artery ligation resulted in 70 per cent mortality within one hour. In a second group of 10 dogs the coronary sinus was arterialized from the left subelavian artery and the sinus mean pressure was held at 50 mm. Hg. In this group circumflex artery ligation resulted in 100 per cent survival for one hour. Statistical analysis shows the results to be highly significant. The results strongly suggest that arterialization of the coronary sinus protects the hearts of dogs from ventricular fibrillation following coronary iartery-ligation.AFWTERt some years of animal research Beck and his associates1-4 have reported remarkable success in attempts to revascularize the heart. The technic at present employs a vein graft between the aorta and the coronary sinus. Some three weeks later the coronary sinus is partially occluded near its ostium. Following these procedures they have ligated a major branch of the coronary arterial system with a remarkably low mortality when compared with the mortality from coronary ligation in normal dogs. There is no doubt that these operations protect dogs from the generally disastrous effects of a major coronary occlusion. However, the mechanism of this protection has not been critically studied and at present is only theoretic.
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