METHODS: Using our adult porcine model, general anesthesia was induced and a complete cardiectomy was performed following cardioplegic arrest. Back-table instrumentation was completed and normothermic ex vivo heart perfusion (NEHP) was initiated in a nonworking heart mode (Langendorff). After 1 h of resuscitation and recovery, LA perfusion was initiated and the heart was transitioned to a coronary flow-only working heart mode for 30 min. Baseline working heart parameters were documented and the heart was returned to nonworking mode. Working heart assessments were performed for 30 min every 6 h for 24 h.
RESULTS: Twenty-four-hour NEHP on 9 consecutive hearts (280 ± 42.1 g) was successful and no significant differences were found between working heart parameters at baseline and after 24 h of perfusion. There was no difference between initial and final measurements of LA mean pressures (5.0 ± 3.1 versus 9.0 ± 6.5 mm Hg, P = 0.22), left ventricular systolic pressures (44.3 ± 7.2 versus 39.1 ± 9.0 mm Hg, P = 0.13), mean aortic pressures (30.9 ± 5.8 versus 28.1 ± 8.1 mm Hg, P = 0.37), and coronary resistance (0.174 ± 0.046 versus 0.173 ± 0.066 mL/min/g, P = 0.90). There were also no significant differences between lactate (2.4 ± 0.5 versus 2.6 ± 0.4 mmol/L, P = 0.17) and glucose (173 ± 75 versus 156 ± 70 mg/dL, P = 0.37).
CONCLUSIONS: A novel model using intermittent LA perfusion to create a coronary flow-only working heart mode for assessment of ex vivo cardiac function has been successfully developed.
方法:使用我们的成年猪模型,在心脏停搏后诱导全身麻醉并进行完整的心脏切除术.完成后台仪器,并以非工作心脏模式(Langendorff)开始常温离体心脏灌注(NEHP)。复苏和恢复后1小时,开始LA灌注,并将心脏转换为仅冠状动脉血流工作心脏模式30分钟。记录基线工作心脏参数,并将心脏恢复到非工作模式。每6小时进行30分钟的工作心脏评估,持续24小时。
结果:对9个连续心脏(280±42.1g)进行24小时NEHP是成功的,并且在基线和灌注24小时后的工作心脏参数之间没有发现显着差异。LA平均压力的初始和最终测量值之间没有差异(5.0±3.1对9.0±6.5mmHg,P=0.22),左心室收缩压(44.3±7.2对39.1±9.0mmHg,P=0.13),平均主动脉压(30.9±5.8对28.1±8.1mmHg,P=0.37),和冠状动脉阻力(0.174±0.046对0.173±0.066mL/min/g,P=0.90)。乳酸之间也没有显着差异(2.4±0.5对2.6±0.4mmol/L,P=0.17)和葡萄糖(173±75对156±70mg/dL,P=0.37)。
结论:已成功开发了一种新型模型,该模型使用间歇性LA灌注来创建仅冠状动脉血流的工作心脏模式来评估离体心脏功能。