CORONARY SINUS CATHETERIZATION FOR STUDYING CORONARY BLOOD FLOW AND MYOCARDIAL METABOLISM

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Abstract
A systematic coronary sinus catheterization technique, under fluoroscopic control, was developed in intact dogs preliminary to trials in man. Coronary blood flows, measured repeatedly in the same dogs over several months, by the nitrous oxide method of Kety & Schmidt, were 70-100 cc/100 g./min., or 4-5% of cardiac output. Myocardial oxygen consumption was 10-12 cc/100 g./min., about 10% of the total oxygen consumption, coronary A-V differences being 2-3 times the systemic. A high myocardial lactate and pyruvate utilization was consistently found, with a less consistent and relatively lower glucose utilization. Endocardial damage was not entirely avoidable in dogs, after catheterizing either the pulmonary artery or the coronary sinus, although technical refinements minimized the size and occurrence of lesions. More serious coronary venous thrombosis and myocardial hemorrhage from coronary venous obstruction (obstruction detected by high pulse pressures recorded through the catheter on deep insertion), were consistently avoided only by precautions, including gentle insertion of a small catheter only 1-2 cm. into the coronary sinus.