Abstract
Preservation of left ventricular systolic function in patients with severe proximal 3-vessel coronary artery disease is not uncommon. This discrepancy between a markedly decreased nutritional flow and a preserved contractility raises the question of a possible collateral blood supply to the myocardium through anastomosis between coronary vessels and other intrathoracic circulations. This possibility is substantiated by the observation in some patients during coronary surgery of a back flow of blood in the coronary artery during cardioplegia despite cross clamping of the aorta, indicating the presence of collateral circulation from an extracardiac origin. Anastomosis between the bronchial and the coronary arteries has been found in several anatomic studies 1–4 and have been documented at angiography. 5 Furthermore, disruption of the suture of the bronchial or tracheal anastomosis is less frequent after combined heart lung transplantation than after lung transplantation, probably as a consequence of anastomosis between the coronary and bronchial circulations. 6 These observations led us to investigate the possibility of a bronchocoronary collateral circulation in patients with 3-vessel disease and normal left ventricular function.
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