Mechanism of myocardial ischemia with an anomalous left coronary artery from the right sinus of Valsalva

The Journal of Thoracic and Cardiovascular Surgery
Carlo R BartoliRobert D Dowling

Abstract

An ectopic coronary artery that courses between the aortic root and the pulmonary trunk may lead to sudden cardiac death, especially in athletes. It has been speculated that during exercise, compression of the coronary artery between the great vessels may impair coronary blood flow and produce myocardial ischemia and fatal arrhythmia. However, this hypothesis cannot be tested in humans, and little experimental data exist to explain this phenomenon. To this end, in a calf with an anomalous left coronary artery that coursed from the right sinus of Valsalva between the great vessels, we assessed for myocardial ischemia during pharmacologically induced tachycardia and hypertension. We identified a juvenile male calf (103 kg) with an anomalous left coronary artery from the right sinus of Valsalva that coursed between the great vessels. Via thoracotomy, the animal was instrumented for hemodynamic measurements. Intravenous dobutamine increased heart rate and myocardial metabolic demands. Intravenous phenylephrine produced arterial hypertension and increased myocardial metabolic demands. Fluorescent-labeled microspheres were used to map regional myocardial blood flow, and hemodynamics were recorded during each condition. Masson's trich...Continue Reading

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Citations

Apr 25, 2014·Cardiology in the Young·Julien I E Hoffman
Oct 5, 2014·General Thoracic and Cardiovascular Surgery·Ippei TakazawaYoshio Misawa
Oct 22, 2013·The Journal of Thoracic and Cardiovascular Surgery·Carlo R BartoliGeorge M Pantalos
Oct 22, 2013·The Journal of Thoracic and Cardiovascular Surgery·Carlo R BartoliStanley E D'Souza
Sep 8, 2015·The International Journal of Cardiovascular Imaging·Nam Ju Lee, Harold Litt
Feb 28, 2013·Internal Medicine Journal·C Barnett
Jan 16, 2014·International Journal of Cardiology·Shu-Shui WangJian Zhuang
Aug 11, 2018·Seminars in Cardiothoracic and Vascular Anesthesia·Benjamin KloeselJohn L Bass
Jul 22, 2017·Circulation Research·Jooeun KangCarlo R Bartoli
Dec 30, 2015·Journal of the Belgian Society of Radiology·Hatice KaplanogluBurhan Yilmaz
Oct 24, 2017·Veterinary Sciences·Brian A Scansen

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