Effect of Epivascular Cardiac Autonomic Nerve Stimulation on Cardiac Function Mariko Kobayashi, MD, Seiichiro Sakurai, MD, Tohru Takaseya, MD, PhD, Akira.

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Effect of Epivascular Cardiac Autonomic Nerve Stimulation on Cardiac Function Mariko Kobayashi, MD, Seiichiro Sakurai, MD, Tohru Takaseya, MD, PhD, Akira Shiose, MD, PhD, Hyun-Il Kim, MD, Masako Fujiki, MD, Jamshid H. Karimov, MD, PhD, Raymond Dessoffy, AA, Alex Massiello, MEBME, Allen G. Borowski, RDCS, David R. Van Wagoner, PhD, Eugene J. Jung, BSME, Kiyotaka Fukamachi, MD, PhD The Annals of Thoracic Surgery Volume 94, Issue 4, Pages 1150-1156 (October 2012) DOI: 10.1016/j.athoracsur.2012.04.092 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Optimal epivascular cardiac plexus stimulation (CPS) positions A and B (dorsal view of the heart). (Ao = aorta; IVC = inferior vena cava; LA = left atrium; LV = left ventricle; rPA = right pulmonary artery; RV = right ventricle; SVC = superior vena cava.) The Annals of Thoracic Surgery 2012 94, 1150-1156DOI: (10.1016/j.athoracsur.2012.04.092) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Surgical access for epivascular stimulation (catheter placed at the cranial side of the right PA [position A] in Fig 1). The asterisk (*) between dotted lines indicates the pathway of the right pulmonary artery (PA). (B) Epivascular stimulation point (position A) seen by angiography. The Annals of Thoracic Surgery 2012 94, 1150-1156DOI: (10.1016/j.athoracsur.2012.04.092) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Data supporting the direct relationship between increasing cardiac plexus stimulation (CPS) voltage and the degree of arterial pressure (AoP) increase. The Annals of Thoracic Surgery 2012 94, 1150-1156DOI: (10.1016/j.athoracsur.2012.04.092) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Effects of cardiac plexus stimulation (CPS) on the left ventricular (LV) pressure-volume loops during inferior vena cava occlusion. (Ees = end-systolic elastance.) The Annals of Thoracic Surgery 2012 94, 1150-1156DOI: (10.1016/j.athoracsur.2012.04.092) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions