Venous stasis in the coronary circulation: An experimental study

Abstract

The purpose of this article is to record data concerning stasis in the venous circulation of the heart. Any addition to the methods of treating coronary artery disease should be investigated. The available medical methods by drugs and rest are indirect. Perhaps a direct operative method can be evolved which will improve the vascular bed in the heart. Ligation of a major vein and a major artery elsewhere in the circulatory tree has received considerable study. Both clinical and experimental observations support the conclusion that after a major artery to an extremity has been ligated the incidence of ischemic necrosis in the extremity is reduced by ligation also of the major vein. Surgeons accept this as a principle in surgery. According to Halsted, the idea originated with the Russian surgeon Von Oppel, 1 in 1908. On the basis of clinical observations Sir George Makins 3, 4 became an advocate of vein ligation with the artery. There are now considerable experimental data on this subject. Some of the experimental data are conflicting. In general, however, it appears that the incidence of necrosis is reduced by ligation of the vein with the artery. A brief résumé of this experimental work is given.