Abstract：
BACKGROUND: Cold static storage and normothermic ex vivo heart perfusion are routinely limited to 6 h. This report describes intermittent left atrial (LA) perfusion that allows cardiac functional assessment in a working heart mode.
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.
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.
摘要：
背景：低温静态存储和常温离体心脏灌注通常限于6小时。该报告描述了间歇性左心房（LA）灌注，可以在工作心脏模式下进行心脏功能评估。
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。
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。
