'Alternate channel' approaches seek to limit myocardial damage

Abstract

Coronary veins are being used as alternate channels in new techniques that seek to limit myocardial damage from coronary occlusions or in connection with cardiac surgery. Some of these new techniques still are undergoing preclinical study. Others already have entered the operating room. Many were discussed in Vienna recently at the First International Symposium on Protection of the Myocardium via the Coronary Sinus. These new approaches through the coronary sinus also might increase the efficacy of pharmacologic agents such as streptokinase, the prostaglandins, mannitol, and antiarrhythmic drugs, several participants indicated. The emphasis on the coronary system reflects a rejuvenation of interest in work carried out by Claude Beck, MD, more than 40 years ago. He attempted to treat myocardial ischemia by creating a shunt between the aorta and the coronary sinus. Although short-term improvements in heart function were seen in about 60% of the 200 patients who underwent Beck's operation,