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Long-term heart preservation by intermittent perfusion with crystalloid medium
1Department of Internal Medicine, University of California School of Medicine, Davis 95616.
The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1993
Summary
Intermittent coronary perfusion for heart preservation showed some loss of contractile function but better outcomes than submersion storage. This method offers comparable function to continuous perfusion after 12-hour hypothermic preservation.
Area of Science:
- Cardiology
- Transplantation Biology
- Biomedical Engineering
Background:
- Intermittent coronary perfusion is a common cardioplegia technique.
- Its efficacy in long-term heart preservation remains under-investigated.
Purpose of the Study:
- To evaluate the recovery of physiologic function in hearts preserved with intermittent coronary perfusion after prolonged hypothermic storage.
- To compare intermittent perfusion with continuous perfusion and submersion storage methods.
Main Methods:
- Isolated rat hearts were divided into five groups: control, continuous perfusion, two intermittent perfusion protocols (5/25 min and 10/25 min cycles), and submersion storage.
- Hearts were preserved for 12 hours in an oxygenated crystalloid medium at hypothermic conditions.
- Postpreservation function was assessed over 4 hours at 37°C in a working heart system.
Main Results:
- Intermittent perfusion led to increased coronary resistance and higher excess lactate production compared to other perfusion groups.
- Submersion-stored hearts showed no recovery of ventricular function.
- While intermittent perfusion resulted in reduced contractile function and compliance versus controls, it preserved function better than submersion storage and similarly to continuous perfusion.
Conclusions:
- Intermittent coronary perfusion, despite causing some contractile dysfunction and decreased compliance, provides superior heart preservation compared to simple submersion storage after 12 hours.
- Its functional recovery is comparable to continuous perfusion, suggesting potential for clinical application in extended hypothermic heart preservation.