Visualization of the Coronary Arteries during Life

Abstract

By retrograde catheterization of the carotid or the brachial arteries small polyethylene or woven catheters have been inserted into the ascending aorta in 10 individuals. Diodrast or Neo-Iopax solution was forcibly injected and serial roentgenograms were rapidly taken. The coronary arteries or branches were demonstrated in 5 of the subjects. Similar studies were made in 5 dogs with normal hearts, and also in 10 dogs in whom a coronary artery had previously been obstructed. In certain of the normal animals not only the larger, but also smaller branches were clearly shown and the absence of filling in obstructed vessels was demonstrated.R OENTGEN visualization of the coronary arteries in the living patient would contribute greatly to the diagnosis of coronary artery disease. It also should be helpful in studying the results of experimentally induced coronary obstruction in animals. With these objectives in mind, a technic of coronary arteriography which has proved successful in animals and in man is presented.In an earlier communication' a method of visualization of the coronary arteries was described. A radiopaque medium was injected through a catheter inserted via the brachial artery into the ascending aorta and the coronary arteries were demonstrated roentgenographically. These studies have been continued and, to date, successful visualization of the coronary arteries in 13 dogs and 5 human beings has been obtained.

Monroe J. Schlesinger's Radiographic Visualization of the Coronary Arteries in Postmortem Hearts and Its Clinical Applications

“…Further refinements in 1951 led to a paradigm shift in diagnosing improvement in clinical coronary disease in men. 21 Selective coronary angiography, first reported by its innovator, Mason Sones, at the Xth International Congress of Radiology in 1962 greatly advanced clinical angiographic correlations. 22 Because of these technological advances, cardiologists eventually had a firm basis for making specific diagnoses and recommending individualized treatments.…”

Coronary Artery Catheterization During Thoracic Aortography

“…Jonsson et al (1951), discussing thoracic aortography for the demonstration of patent ductus arteriosus and coarctation, state that the catheter tip "may fasten in the orifice of one of the coronary arteries, with perhaps fatal results." Helmsworth et al (1950) reported their attempts at coronary arteriography in six patients, two of whom died following repeated injection of contrast medium. As DiGuglielmo and Guttadauro (1952) indicate in their monograph on coronary arteriography, such repeated injections constitute a series of periods of myocardial anoxia.…”

Venous System of the Myocardium with Special Reference to the Conduction System

“…It will be noted in figure 5 that three veins were selected crossing the fibrous ring and included in the model, while only two were incorporated in the model shown in figure 6. In both instances many additional arterial and venous vessels were present in the serial sections but were omitted to facilitate the mechanics of model construction and preserve simplicity.…”

“…This model, made from the heart of a 6 month old fetus and comprising 90 In figure 8, we have rearranged a schema based on the work of Wearn, Mettier, Klumpp and Zschiesche35 to demonstrate the relations of the described sinusoids and common bundle (see figures 5 and 6) to the remainder of the tions the blood flow might well be in a reverse direction to that now indicated by the broken lines in figure 8. For example, it is interesting to speculate that such a reversal of flow may account, for the low incidence of heart block observed following the gradual occlusion of the coronary arteries.…”