Effects of obstruction of cardiac lymphatics.

A study was undertaken in the dog to determine whether changes occurred in the lymphatics of the endocardium and myocardium of both ventricles after obstruction of the cardiac lymphatics. Other investigators have reported ventricular subendocardial hemorrhage, increased elastic and fibrous tissue in the left ventricle endocardium, and opacification of the mitral valve leaflets. In 14 experiments the ventricular walls were injected with India ink. The efferent cardiac lymphatics were followed to their termination in the cardiac lymph node or nodes. These nodes were excised, as were afferent and efferent lymphatic trunks. After 4 to 16 weeks, with the aid of extracorporeal circulation and oxygenation, biopsies were taken of the myocardium and endocardium of the ventricles of the beating heart. Six animals were used as control subjects. Grossly, there were no changes in the endocardium, myocardium, or valve leaflets. Light and electron microscopy demonstrated no fibrosis or elastosis, and no lymphatics were identifiable. We were unable to establish evidence of permanent changes as a result of obstruction of the lymphatics of the dog heart.