Autologous blood perfusion for myocardial protection during coronary angioplasty: A feasibility study

Abstract

During coronary angioplasty, inflation of the balloon within the coronary artery produces transient arterial occlusion and frequently results in myocardial ischemia. Delivery of oxygenated autologous blood to the myocardium at risk during inflation may help mitigate this ischemia. Accordingly, we investigated the feasibility and safety of infusing blood through the central lumen of a dilatation catheter around the guidewire using both a model in vitro and clinical trials. In the tests in vitro, fresh blood was infused at flow rates up to 120 ml/min. Hemolysis was minimal at flow rates of 60 ml/min or less (≤ 0.92 ± 0.18%), but increased exponentially at higher rates (13.64 ± 2.37% at 120 ml/min, p < .003). Relative to baseline, the maximum ST segment elevation during the perfusion inflation (0.5 ± 0.3 mm) was nearly one-fourth that during the control inflation (1.9 ± 0.6 mm, p