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Coronary Collateral Development: Concepts and Hypotheses

  • Chapter
Collateral Circulation

Abstract

From the 1930s to the early 1960s it was believed that coronary collaterals were present in only about 4% of human hearts and that they open up passively under the influence of pressure gradients, i.e., in the presence of stenoses or occlusions. There were hints but no evidence that collaterals might develop: Eckstein (1) had shown that peripheral arterial(stump) pressure in some vascular provinces needed some time to rise after acute occlusion. Fulton (2) was the first to show that all normal human hearts had small collaterals and that hearts with coronary heart disease usually had much larger collaterals and that passive enlargement was unlikely merely on the basis of the difference of tissue mass. Fulton had re-discovered an observation by Spalteholz (3) that got lost because the “new” X-ray technique was unable in the 1930s to resolve small but visible arterioles.

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“It often matters less that a hypothesis is right or wrong than that it is fruitful”.

Judah Folkman

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Authors and Affiliations

  1. Max-Planck-Institute, Department of Experimental Cardiology, Bad Nauheim, F. R. Germany

    Wolfgang Schaper

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  1. Wolfgang Schaper
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Editors and Affiliations

  1. Department of Experimental Cardiology, Max-Planck-Institute, Benekestrasse 2, D-6350, Bad Nauheim, F. R. Germany

    Wolfgang Schaper M.D., Ph.D.  & Jutta Schaper M.D., Ph.D.  & 

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Schaper, W. (1992). Coronary Collateral Development: Concepts and Hypotheses. In: Schaper, W., Schaper, J. (eds) Collateral Circulation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3092-3_4

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  • DOI: https://doi.org/10.1007/978-1-4615-3092-3_4

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