Coronary venous retroperfusion: An old concept, a new approach

Ghassan S. Kassab, Jose A. Navia, Keith March, Jenny Susana Choy

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


The potential of the coronary veins for revascularization has been evaluated by many investigators for more than a century. The major hurdle has been the damage of veins during sudden exposure to arterial pressure. The solution to this problem has typically involved the use of intricate and complicated apparatus and devices, which has prevented routine clinical utility in the catheterization laboratory. This review examines this old concept from a new perspective and proposes a novel hypothesis to address previous shortcomings. We speculate on an approach that may serve to eliminate the edema and hemorrhage that result during venous retroperfusion as the pressure is suddenly increased to arterial values. We propose the rationale to increase the venous pressure to arterial values more gradually to allow prearterializations of the veins before full exposure of arterial pressure. Finally, we discuss various possible indications for this selective autoretroperfusion strategy to combat myocardial ischemia in cardiogenic shock patients, ST-elevation myocardial infarct patients, no-option patients, and beyond.

Original languageEnglish (US)
Pages (from-to)1266-1272
Number of pages7
JournalJournal of Applied Physiology
Issue number5
StatePublished - May 2008


  • Coronary veins
  • Myocardial ischemia
  • Remodeling

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Endocrinology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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