Document Detail


Long-term heart preservation by intermittent perfusion with crystalloid medium.
MedLine Citation:
PMID:  8231202     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was undertaken to determine whether hearts preserved with intermittent coronary perfusion would recover physiologic function after a prolonged period of hypothermic preservation. Intermittent perfusion is commonly used for cardioplegia, but its efficacy in long-term heart preservation has not yet been demonstrated. Five groups of isolated rat hearts were studied (n = 7 per group): (1) fresh nonpreserved control hearts; (2) hearts preserved with continuous low-pressure perfusion via the aorta; (3) hearts preserved with cycles of 5 minutes of perfusion followed by 25 minutes of nonperfusion; (4) hearts preserved with cycles of 10 minutes of perfusion followed by 25 minutes of nonperfusion; (5) hearts preserved with submersion storage without perfusion. An oxygenated extracellular-type crystalloid medium (oxygen tension = 820 +/- 5 mm Hg) was used as a preservation medium; preservation was for 12 hours. During preservation, the coronary resistance of the intermittent perfusion-preserved hearts increased significantly, and these hearts produced significantly more excess lactate than did hearts in the other two preservation groups. The submersion-stored hearts exhibited no postpreservation ventricular function in an isolated perfused working rat heart system. The poststorage function of the other four groups, which was quantified during a 4-hour, 37 degrees C perfusion period at constant heart rate, indicated that there were no significant group differences with respect to output or energetics (coronary flow, aortic output, cardiac output, myocardial oxygen consumption, and external work efficiency). The intermittent perfusion-preserved hearts had significantly lower postpreservation contractile function (left ventricular systolic pressure, peak rates of left ventricular pressure development and relaxation, peak aortic flow rate, stroke work, and peak power) and higher left ventricular end-diastolic pressure compared with the control group. Although hearts preserved with intermittent perfusion had a loss of contractile function and decreased compliance compared with fresh hearts, after preservation they had better function than did hearts preserved with submersion storage and the same function as hearts preserved with continuous perfusion.
Authors:
L D Segel; D M Follette
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  106     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-12-08     Completed Date:  1993-12-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  811-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of California School of Medicine, Davis 95616.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure
Cardiac Output
Cardioplegic Solutions
Coronary Circulation
Heart* / physiology
Lactates / metabolism
Lactic Acid
Male
Myocardium / metabolism
Organ Preservation / methods*
Oxygen Consumption
Perfusion / methods*
Potassium Compounds
Rats
Rats, Sprague-Dawley
Grant Support
ID/Acronym/Agency:
R01 HL30065/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cardioplegic Solutions; 0/Lactates; 0/Potassium Compounds; 0/potassium cardioplegic solution; 50-21-5/Lactic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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