Ventral cardiac denervation: Is it truly an effective prophylaxis against atrial fibrillation after coronary artery bypass grafting?

Ventral cardiac denervation increased right coronary arterial blood flow

BACKGROUND

Cardiac denervation accompanied with coronary artery bypass surgery has been widely performed for the treatment of vasospastic angina associated with atherosclerotic coronary artery disease. However, the effect of cardiac denervation on phasic coronary blood flow patterns of the left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX) and right coronary artery (RCA) remains unknown. This study aimed to investigate the effect of cardiac denervation on phasic coronary blood flow patterns of the LAD, LCX and RCA.

METHODS

Phasic coronary blood flow patterns were analyzed using three flow probes placed around the LAD, LCX and RCA with and without LAD stenosis. Ventral cardiac denervation (VCD) was performed in 8 pigs, and 16 pigs were used as control subjects. Autonomic activities before and after the VCD were quantified by wavelet analysis of heart rate variability.

RESULTS

The mean LAD flow (34.4+/-9.4 to 32.6+/-7.1 ml/min, p=0.638) and mean LCX flow (26.3+/-10.2 to 27.2+/-6.0 ml/min, p=0.825) showed no significant change after VCD, while the mean RCA flow (31.3+/-9.0 to 38.2+/-11.2 ml/min, p=0.003) significantly increased. The hemodynamic variables in the VCD group were well maintained after creation of LAD stenosis, while they deteriorated in the control group. The low-frequency components, high-frequency components and their ratio did not change after VCD.

CONCLUSIONS

VCD prevented the deterioration of cardiac function after creation of an LAD stenosis and resulted in an increase of the mean RCA flow. VCD did not affect autonomic nervous system activity.