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August 1983

'Pulsatile' Left Atrial-Femoral Artery BypassA New Method of Preventing Extension of Myocardial Infarction

Author Affiliations

From the Divisions of Cardiovascular Surgery, Departments of Surgery, New York University Medical Center, New York (Drs Laschinger, Catinella, Glassman, and Spencer, and Mr Knopp), and Maimonides Medical Center (Dr Cunningham).

Arch Surg. 1983;118(8):965-969. doi:10.1001/archsurg.1983.01390080067017

• A left atrial—femoral artery (LA-FA) bypass system was designed to deliver synchronous pulsatile blood flow. We compared it with nonpulsatile LA-FA bypass in its effectiveness to limit infarct extension after ligation of the left anterior descending coronary artery at its origin in 35 dogs. Nonpulsatile LA-FA bypass resulted in a 70% reduction in the size of infarct. The addition of synchronous diastolic counterpulsation (P—LA-FA) further reduced the size of infarct, when compared with that in controls (95%) or animals that underwent LA-FA bypass (83%). Both LA-FA and P—LA-FA bypasses limited infarct extension and reduced mortality after acute coronary occlusion through effective unloading of the left ventricle. The addition of diastolic counterpulsation to LA-FA bypass led to further significant infarct reduction, when compared with LA-FA bypass alone. These effects were most likely secondary to improvements in myocardial blood flow distribution.

(Arch Surg 1983;118:965-969)