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Updated: Jul 22, 2026
Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism
Published on: January 12, 2019
Myocardial Work Index as an Indicator of Cardiac Function in Ex Situ Heart Perfusion
Dorothee Brunet1, Simon Dang Van2, Martin Klockner1
1Department of Cardiac Surgery and Transplantation, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis Robinson, France.
None:
Heart transplantation is increasingly reliant on marginal grafts due to organ shortages. Ex situ heart perfusion (ESHP) enables viability assessment, but current methods lack functional evaluation. We aimed to investigate the relationship between echocardiographic myocardial work index (MWI) and cardiac performance during ESHP. Eighteen pig hearts were assigned to three groups: cold storage (BH-CS), hypothermic perfusion (BH-HP), and circulatory death (DCD). Normothermic ESHP was conducted using a working-mode setup. Cardiac output differed significantly among groups (BH-CS: 1200±573 mL/min, BH-HP: 1592±193, DCD: 676±234, p=0.012) as did MWI (440±124 mmHg%, 652±157 mmHg%, 292±122 mmHg%, p<0.001). MWI strongly correlated with cardiac output (r=0.85, p<0.001). This study demonstrates the feasibility of noninvasive echocardiographic assessment during ESHP. MWI showed a robust correlation with cardiac performance. Although current clinical perfusion systems do not support working-mode evaluation, our findings support the development of such integrated platforms. Limitations include the lack of post-transplantation data and small sample size.
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