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(Circulation. 1952;6:262.)
© 1952 American Heart Association, Inc.

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Further Studies on the Effect of Arteriovenous Fistulas and Elevations of Sinus Pressure on Mortality Rates Following Acute Coronary Occlusions

GEORGE SMITH F.R.C.S.¹; JAMES DEMMING ¹; MORTON ELEFF ¹; RICHARD W. ECKSTEIN M.D.¹

¹ From the Department of Medicine, School of Medicine, Western Reserve University, Cleveland, Ohio.

Observations were made on the mortality rates within the first hour following acute ligation of the circumflex artery. The experiments were divided into the following groups: (1) those with arteriovenous fistulas, (2) those with elevation of coronary sinus pressure, (3) those with complete coronary sinus occlusion, and (4) those with arterialization of the coronary sinus. There was a mortality of 70 per cent in the first group, 30 per cent in the second group, 40 per cent in the third group, and no deaths in the fourth group. The results indicate that arterialization of the coronary sinus provides the greatest protection against ventricular fibrillation and that such arterialization provides the only practical means of chronically elevating coronary sinus pressures to effective levels.