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Coronary microvascular reactivity after ischemic cold storage and reperfusion
C O Murphy1, Pan-Chih, J P Gott
1Department of Surgery, Emory University School of Medicine, Crawford Long Hospital, Atlanta, Georgia 30365-2225, USA.
The Annals of Thoracic Surgery
|January 1, 1997
Summary
Preservation solutions like University of Wisconsin and Roe's solution maintained left ventricular microvascular function after heart transplantation. Crystalloid cardioplegia failed, and right ventricular function remained impaired across all tested solutions.
Area of Science:
- Cardiovascular Research
- Transplantation Immunology
- Vascular Biology
Background:
- Coronary microvascular system is crucial for regulating myocardial perfusion.
- Maintaining microvascular reactivity is vital for transplanted hearts after ischemic storage.
- Endothelium-dependent relaxation of coronary microvessels was investigated in a canine heart transplant model.
Purpose of the Study:
- To evaluate the impact of different preservation solutions on coronary microvascular reactivity post-heart transplantation.
- To compare the efficacy of crystalloid cardioplegia, Roe's solution, and University of Wisconsin solution in preserving microvascular function.
- To assess endothelium-dependent and independent microvascular responses in transplanted canine hearts.
Main Methods:
- Canine hearts underwent 3-hour ischemic cold storage using crystalloid cardioplegia, Roe's solution, or University of Wisconsin solution.
- Coronary microvessels (100-200 microns) were analyzed using video microscopy after 1 hour of reperfusion.
- Vascular responses to acetylcholine and nitroprusside were measured to assess endothelium-dependent and independent relaxation.
Main Results:
- University of Wisconsin solution and Roe's solution preserved left ventricular microvascular relaxation, unlike crystalloid cardioplegia (p < 0.05).
- Right ventricular microvascular relaxation was consistently lower than left ventricular relaxation across all groups (p < 0.05).
- Endothelium-independent relaxation to nitroprusside was similar to controls, indicating preserved smooth muscle function.
Conclusions:
- Roe's solution and University of Wisconsin solution effectively preserved left ventricular microvascular relaxation following ischemic cold storage.
- All preservation methods resulted in impaired right ventricular microvascular relaxation, though University of Wisconsin solution showed superiority.
- Microvascular dysfunction may contribute to right ventricular dysfunction post-transplantation, highlighting the importance of preservation solution choice for endothelial integrity.