Abstract
Although a remarkable development has been achieved in cardiac surgery for many kinds of congenital and acquired cardiac diseases, a lot of problems remain unsolved in regard to the treatment of coronary artery disease which holds an important position in acquired cardiac diseases. During ventricular diastole, coronary blood flow, in general, reaches the maximum rate with the relative lack of flow in the forward direction in the aortic root because of the closure of the aortic valve. In the previous studies on Synchronized Arterial Counterpulsation, a method of assisted circulation for left-sided heart failure, the authors noticed that this method caused remarked increase of coronary blood flow. Thus, the authors presumed that the coronary arteries could be selectively opacified with contrast medium infused by a special pump (Davol Heart Pump) used in this method. This presumption has been experimentally and clinically proved to be valid in Coronary Arteriography Using Successive Diastolic Injections. Since, in the next series of the studies, the authors confirmed that an agent such as Evans Blue infused into the aortic root by this method of successive diastolic injections more rapidly reached the coronary arteries at a much higher concentration, it appeared reasonable that this infusion method might be the most rational one for administrating such agents as fibrinolysin, anticoagulants, coronary dilators, etc. which should desirably act directly upon the coranary artery and/or the myocardium. The author has designated this method "Selective Coronary Artery Infusion", and has investigated to evaluate the possibility of its clinical application. It is an indisputable fact that there is a limit to the effect or the indication of the medical and surgical treatments of coronary insufficiency. The clinical usefulness and effect of Selective Coronary Artery Infusion may be highly expectable, since tne administration of the above agents by this method is a more rational and positive means than any medical remedy and has a possibility to be applied to the pre- and post-operative managements in the surgical treatment.