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

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

Editorial.- record of the overseas operating workforce on coronary sinus interventions.- The so-called “silent quarter” of the coronary sinus.- influx, outflow and pressures within the coronary circulation.- Coronary sinus interventions: scientific application.- The promise and boundaries of coronary venous retroperfusion: classes from the prior and new directions.- Synchronized coronary sinus retroperfusion present scientific perspective.- PICSO prestige file 1985.- Retrograde cardioplegia: myocardial security through the coronary veins — 1986.- Technological elements of coronary sinus interventions.- execs and cons — coronary sinus intervention vs. traditional therapy.- CSI: transitority aid or long term remedy.

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Katz (66) found the outflow by the drainage channels (coronary sinus, Thebesians and right heart veins) to be widely variable. A. 40 drainage by the coronary sinus alone varied from 17-44% (average 32%). 3% into the left ventricle. Prinzmetal (96) utilized radioactive erythrocides and glass spheres, and established the existence of arterial-venous anastomosis. Gregg (48) performed, in 1947, a classical study of the coronary venous drainage in anaesthetized open chest dogs. Blood flow measurements indicated, as expected, that the right coronary artery is the major source of blood supply of the right ventricle and the anterior cardiac veins its major drainage system.

Kenner T (1975) The central arterial pulses. Pfliigers Arch 353: 67-81 6. Kenner T, Moser M, Mohl W (1984) Wave Reflection and Pressure Flow Relations in the Coronary Circulation. In (14) p 60 7. Kenner T (1967) Neue Gesichtspunkte und Experimente zur Beschreibung und Messung der Arterienelastizitat. Arch Kreisl-Forsch 54: 68-139 8. Kenner T, Moser M, Mohl W (1985) Arteriovenous Difference of the Blood Density in the Coronary Circulation. Transact ASME J BME 107: 34-40 9. Kenner T, Leopold H, Hinghofer-Szalkay H (1977) The continuous high precision measurement of the density of flowing blood.

It has been observed, furthermore, that a reduction of coronary flow by less than 50% leads to a decrease in contractility and therefore tends to reduce the energy consumption of the myocardium (3,19). The arteriovenous difference of the oxygen concentration surprisingly does not rise but in fact decreases during this process. It seems that the myocardium reacts to a decrease in oxygen delivery rather like a primitive cell, the energy consumption of which is purely dependent on input and output without an attempt of a homeostatic control mechanism.

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