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Original communication Society for Vascular Surgery| Volume 37, ISSUE 1, P32-53, January 1955

Revascularization of the heart by pedicled skin flap

An experimental study investigating the functions of extracoronary anastomoses
DOI:https://doi.org/10.5555/uri:pii:003960605590310X
Revascularization of the heart by pedicled skin flap
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      Abstract

      Three experimental methods are described which may be used to study the functions of extracoronary anastomoses produced in the laboratory animal.
      The first is the choice of a pedicled skin flap as the vehicle to bring systemic blood vessels to the surface of the heart. Extracoronary anastomoses formed with the vessels of this tissue are more easily studied than those formed with other tissues, and the procedure is simple to carry out.
      The second is a way to produce slow complete occlusion of a coronary artery without reoperation. This is accomplished by the use of a stainless steel clip which is closed by a spring and is held open by catgut which slowly absorbs after the clip is placed in the tissues.
      The third is a technique for determining the direction of blood flow through extracoronary anastomoses in the living animal, and it consists of a comparison of the times required for blood to reach the coronary sinus by the normal route and by a shorter route through the anastomoses.
      Using these methods we have occluded up to 80 per cent of the coronary arterial supply in animals protected by flaps, and present evidence suggests that the extracoronary source of blood was not responsible for their survival. The findings neither prove nor disprove the value of extracoronary anastomoses, but merely indicate the extent to which the normal heart is capable of protecting its blood supply, following slow occlusion. This method of occlusion requires nearly total coronary artery closure before simulating coronary disease in the human being, and further studies in this direction are being carried out.
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      References

        • Zoll P.M.
        • Wessler S.
        • Blumgart H.L.
        Angina Pectoris, a Clinical and Pathologic Correlation.
        Am. J. Med. 1951; 11: 331
        • Ringler S.H.
        • Bakst H.
        • Rosenfeld S.
        Comparison of the Usefulness of the Dock Electromagnetic Ballistocardiograph and the Exercise Tolerance Test in the Detection of Coronary Insufficiency.
        New York J. Med. 1952; 52: 1277
        • Taymor R.C.
        • Prody L.
        • Chesky K.
        • Moser M.
        • Master A.M.
        The Ballistocardiogram in Coronary Artery Disease.
        J. A. M. A. 1952; 148: 419
        • Crooke G.F.
        Ueber Zwei Seltene und aus Verschiedenen Uraschen Entstandene Falle von Rapider Herzlahmung.
        Virchows Arch. path. Anat. 1892; 129: 186
        • Redwitz E.
        Der Einfluss der Erkrankungen der Koronararterien auf die Herzmuskulatur mit Besonderer Berucksichtigung der Chronischen Aortitis.
        Virchows Arch. path. Anat. 1909; 197: 433
        • Robertson H.F.
        The Vascularization of the Epicardial and Periaortic Fat Pads.
        Am. J. Path. 1930; 6: 209
        • Hudson C.L.
        • Moritz A.R.
        • Wearn J.T.
        The Extracardiac Anastomoses of the Coronary Arteries.
        J. Exper. Med. 1932; 56: 919
        • Moritz A.R.
        • Hudson C.L.
        • Orgain E.S.
        Augmentation of the Extracardiac Anastomoses of the Coronary Arteries Through Pericardial Adhesions.
        J. Exper. Med. 1932; 56: 927
        • Gross L.
        The Blood Supply to the Heart.
        Paul B. Hoeber, Inc, New York1921
        • Zoll P.M.
        • Wessler S.
        • Sehlesinger M.J.
        Interarterial Coronary Anastomoses in the Human Heart With Particular Reference to Anemia and Relative Cardiac Anoxia.
        Circulation. 1951; 4: 797
        • Blumgart H.L.
        • Schlesinger M.J.
        • Davis D.
        Studies on the Relation of the Clinical Manifestations of Angina Pectoris, Coronary Thrombosis and Myocardial Infarctions to the Pathologic Findings.
        Am. Heart J. 1940; 19: 1
        • Prinzmetal M.
        • Simkin B.
        • Bergman H.C.
        • Kruger H.E.
        Studies on the Coronary Circulation.
        Am. Heart J. 1947; 33: 420
        • Eckstein R.W.
        • Gregg D.E.
        • Pritchard W.H.
        The Magnitude and Time of Development of the Collateral Circulation in Occluded Femoral, Carotid and Coronary Arteries.
        Am. J. Physiol. 1941; 132: 351
        • Beck C.S.
        • Tichy V.L.
        • Moritz A.R.
        Production of a Collateral Circulation to the Heart.
        in: Proc. Soc. Exper. Biol. & Med. 32. 1935: 759
        • O'Shaughnessy L.
        An Experimental Method of Providing a Collateral Circulation to the Heart.
        Brit. J. Surg. 1936; 23: 665
        • Thompson S.A.
        • Plachta A.V.
        Fourteen Years' Experience With Cardiopexy in the Treatment of Coronary Artery Disease.
        J. Thoracic Surg. 1954; 27: 64
        • Thompson S.A.
        • Raisbeck M.J.
        Cardiopericardiopexy; the Surgical Treatment of Coronary Arterial Disease by the Establishment of Adhesive Pericarditis.
        Ann. Int. Med. 1942; 16: 495
        • O'Shaughnessy L.
        Surgical Treatment of Cardiac Ischaemia.
        Lancet. 1937; 232: 185
        • Beck C.S.
        The Development of a New Blood Supply to the Heart by Operation.
        Ann. Surg. 1935; 102: 801
        • Beck C.S.
        Coronary Sclerosis and Angina Pectoris.
        Surg., Gynec. & Obst. 1937; 64: 270
        • Carter B.N.
        • Gall E.A.
        • Wadsworth C.L.
        An Experimental Study of Collateral Coronary Circulation Produced by Cardiopneumonopexy.
        Surgery. 1949; 25: 489
        • Lesuis A.
        Die Anatomischen und Funktionellen Grundlagen der Kunstliehen Blutversorgung der Herzmuskels durch die Lunge bei Coronararterien—Verschlurs.
        Arch. klin. Chir. 1938; 191: 101
        • Beck C.S.
        The Coronary Operation.
        Am. Heart J. 1941; 22: 539
        • Leary T.
        • Wearn J.T.
        Two Cases of Complete Occlusion of Both Coronary Orifices.
        Am. Heart J. 1930; 5: 412
        • Bellet S.
        • Gonley B.A.
        • McMillan T.M.
        Nourishment of the Myocardium Through Thebesian Vessels.
        Arch. Int. Med. 1933; 51: 112
        • Wearn J.T.
        The Role of the Thebesian Vessels in the Circulation of the Heart.
        J. Exper. Med. 1928; 47: 293
        • Gross L.
        • Blum L.
        Effect of Coronary Artery Occlusion on Dog's Heart With Total Coronary Sinus Ligation.
        in: Proc. Soc. Exper. Biol. & Med. 32. 1935: 1578
        • Beck C.S.
        • Stanton E.V.
        • Batiuchok W.J.
        • Lester E.
        Revascularization of Heart by Graft of Systemic Artery Into Coronary Sinus.
        J. A. M. A. 1948; 137: 436
        • McAllister F.F.
        • Leighwinger D.
        • Beck C.S.
        Revascularization of the Heart by Vein Graft From Aorta to Coronary Sinus.
        Ann. Surg. 1951; 133: 153
        • Ochsner A.
        • DeBakey M.
        The Surgical Treatment of Coronary Disease.
        Surgery. 1937; 2: 428
        • Leriche R.
        • Herrmann L.
        • Fontaine R.
        Ligature de la coronaire gauche et fonction cardiaque chez l'animal intact.
        Compt. rend. Soc. biol. 1931; 107: 545
        • Leriche R.
        • Herrmann L.
        • Fontaine R.
        Ligature de la coronaire gauche et fonction du coeur après enervation sympathique.
        Compt. rend. Soc. biol. 1931; 107: 547
        • Vineberg A.
        • Miller D.
        Functional Evaluation of an Internal Mammary Coronary Artery Anastomosis.
        Am. Heart J. 1953; 45: 873
        • Brown J.B.
        • Fryer M.P.
        • McDowell F.
        Permanent Pedicle Blood-Carrying Flaps for Repairing Defects in Avascular Areas.
        Ann. Surg. 1951; 134: 486
        • Braithwaite F.
        Preliminary Innervations of the Vascular Channels in Tube Pedicles.
        Brit. J. Plast. Surg. 1951; 4: 28
        • German W.
        • Finesilver E.M.
        • Davis J.S.
        Establishment of Circulation in Tubed Skin Flaps.
        Arch. Surg. 1933; 26: 27
        • Conway H.
        • Stark R.B.
        • Doktor J.R.
        Vascularization of Tubed Pedicles.
        Plast. & Reconstruct. Surg. 1949; 4: 133
        • Douglas B.
        • Buckholz R.R.
        The Blood Circulation in Pedicle Flaps.
        Ann. Surg. 1943; 117: 692
        • Douglas B.
        • Millikan G.A.
        The Blood Circulation in Pedicle Flaps.
        Plast. & Reconstruct. Surg. 1947; 2: 348
        • von Wedel J.
        • Stone P.W.
        • Neumann C.G.
        • Lord Jr., J.W.
        • Hinton J.W.
        • Moran R.E.
        Revascularization of the Heart by a Pedicle Skin Flap.
        Science. 1952; 116: 319
        • Neumann C.G.
        The Use of Large Buried Pedicled Flaps of Dermis and Fat; Clinical and Pathological Evaluation in the Treatment of Facial Hemiatrophy.
        Plast. & Reconstruct. Surg. 1953; 11: 315
        • Moran R.E.
        • Neumann C.G.
        • von Wedel J.
        • Lord Jr., J.W.
        • Stone P.W.
        • Hinton J.W.
        Revascularization of the Heart by Tubed Pedicled Graft of Skin and Subcutaneous Tissue.
        Plast. & Reconstruct. Surg. 1952; 10: 295
        • Gregg D.E.
        Coronary Circulation in Health and Disease.
        Lea & Febiger, Philadelphia1950
        • Neumann C.G.
        • Moran R.E.
        • von Wedel J.
        • Lord Jr., J.W.
        • Hinton J.W.
        Reduction of Coronary Artery Blood Flow Preparatory to Revascularization of the Heart via Pedicled Flap of Skin.
        Plast. & Reconstruct. Surg. 1954; 13: 35
        • Newman E.V.
        • Merrell M.
        • Genecin A.
        • Monge C.
        • Milnor W.R.
        • McKeever W.P.
        The Dye Dilution Method for Describing the Central Circulation.
        Circulation. 1951; 4: 735
        • Kantrowitz A.
        • Kantrowitz A.
        Experimental Augmentation of Coronary Flow by Retardation of the Arterial Pressure Pulse.
        Surgery. 1953; 34: 678

      Article info

      Footnotes

      ☆Read at the eighth annual meeting of the Society for Vascular Surgery, San Francisco, June 20, 1954.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:003960605590310X

      Copyright

      © 1955 Published by Elsevier Inc.

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