Refinement of pig retroperfusion technique: Global retroperfusion with ligation of the azygos connection preserves hemodynamic function in an acute infarction model in pigs (Sus scrofa domestica)

In ischemic hearts, venous retroperfusion is a potential myocardial revascularization strategy. This study aimed to refine the technical and functional aspects of a pig model of acute myocardial infarction and retroperfusion with respect to the azygos connection. Global retroperfusion after ligation of the ramus interventricularis paraconalis (equivalent to the left anterior descending artery in humans) was performed in 16 Landrace pigs (Sus scrofa domestica). Coronary sinus perfusion was performed in 8 pigs (P+) but not in the other 8 (P-), and the azygos vein was ligated (L+) 4 of the 8 pigs in each of these groups but left open (L-) in the remaining animals. Hemodynamic performance (for example, cardiac output, stroke volume) was significantly better in P+L+ pigs that underwent coronary sinus perfusion with ligation of the azygos vein compared with all other animals. In addition, troponin I release was significant lower in P+L+ pigs (1.7 ± 1.3 ng/mL) than in P-L- (5.47 ± 2.1 ng/mL), P-L+ (6.63 ± 2.4 ng/mL), and P+L- (4.81 ± 2.3 ng/mL) pigs. Effective retrograde flow and thus hemodynamic stability was achieved by ligation of the azygos vein. Therefore, experiments focusing on global retroperfusion will benefit from effective inhibition of the blood flow through the azygos vein.