The electrocardiogram following anastomosis of carotid artery to coronary sinus

Abstract

This is a report of the electrocardiographic changes noted after coronary sinus ligation, anastomosis of the carotid artery to the coronary sinus, and subsequent ligation of the descending ramus of the left coronary artery. The changes following ligation of the coronary sinus are similar to those noted by Gross and his colleagues. 2 These changes are transient and reflect disturbance of the myocardium due to mechanical trauma, and perhaps a transient ischemia due to venous congestion. Records taken at the time of anastomosis of the carotid artery to the coronary sinus show extensive changes in the QRS complex, the T waves, and the conductive mechanism. These changes are transient and reflect position change, temperature change, mechanical trauma, and myocardial injury. No change was noted at the moment of release of arterial blood into the sinus. Serial records following ligation of the descending ramus of the left coronary artery in dogs with patent anastomosis showed no sign of infarction in four of nine subjects; four showed suggestive signs of infarction; one showed definite signs of infarction. All survived the immediate postoperative period. In all cases of ligation in which the anastomosis was thrombosed there were signs of myocardial infarction. This evidence suggests that an arterial anastomosis into the coronary sinus will frequently protect the dog's heart against one-step ligation of the anterior descending ramus of the left coronary artery.