Influences of localized aortic valve damage on coronary artery blood flow in acute aortic regurgitation: an experimental study.

Abstract

We examined the influences of localized aortic valve damage on coronary artery blood flow and the prognosis in acute aortic regurgitation. Aortic regurgitation was produced in 18 open-chest dogs by extensively cutting one of the three aortic cusps with a nerve knife introduced via the cardiac apex. The dogs were separated into three groups of six dogs each. In each group the noncoronary cusp (NCC), the right coronary cusp (RCC), or the left coronary cusp (LCC) was cut. Aortic and left ventricular pressures; the phasic aortic, left anterior descending (LAD), and right coronary artery (RCA) blood flows; and electrocardiograms were simultaneously recorded before and after production of acute AR. All dogs in the NCC and RCC groups survived for at least 30 to 60 min, but all dogs in the LCC group died after 5 to 9 min of production of acute AR due to left ventricular failure. After 2 min of aortic regurgitation, the total, systolic, and diastolic LAD flows were 39 +/- 14, 19 +/- 9, and 20 +/- 8 ml/min (mean +/- SD) in the NCC group, 41 +/- 15, 31 +/- 9, and 10 +/- 6 ml/min in the RCC group, and 9 +/- 5, 19 +/- 5, and -10 +/- 2 ml/min in the LCC group, respectively. The corresponding RCA flows were 19 +/- 9, 15 +/- 6, and 4 +/- 3 ml/min in the NCC group, 13 +/- 8, 21 +/- 12, and -8 +/- 4 ml/min in the RCC group, and 14 +/- 4, 19 +/- 4, and -5 +/- 1 ml/min in the LCC group, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)