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Related Experiment Videos

Right ventricular function in the donor heart

S W Kendall1, H B Bittner, D S Peterseim

  • 1Department of General and Cardiothoracic Surgery, Duke University Medical Center, Durham, NC 27710, USA.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|April 1, 1997
PubMed
Summary
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Brain death significantly impairs both right and left ventricular function, with right ventricular injury being more pronounced. This finding may explain post-transplant right ventricular failure.

Area of Science:

  • Cardiology
  • Transplantation Immunology
  • Physiology

Background:

  • Right ventricular failure is a major cause of early morbidity and mortality after cardiac transplantation, often linked to elevated pulmonary vascular resistance.
  • While donor brain death is known to affect left ventricular function, its impact on the right ventricle remains understudied.

Purpose of the Study:

  • To investigate the effects of brain death on right ventricular function using a canine model.
  • To compare the functional changes in the right ventricle versus the left ventricle following induced brain death.

Main Methods:

  • Utilized a canine model with 33 dogs instrumented to measure ventricular dimensions and pressures.
  • Assessed systolic function using preload-independent recruitable stroke work (PRSW) derived from ventricular stroke work and end-diastolic volume during caval occlusion.

Related Experiment Videos

  • Induced brain death via intracranial balloon inflation, maintaining hemodynamic stability without inotropic support, and collected data at baseline, 2, and 4 hours post-induction.

    • Main Results:

    • Brain death induced an initial hyperdynamic response followed by diabetes insipidus.
    • Significant deterioration in both right and left ventricular systolic function was observed 2 hours post-brain death (RV: 34.4% decrease; LV: 20.4% decrease).
    • This functional decline persisted at 4 hours post-brain death, with right ventricular function showing a more prominent decrease compared to the left ventricle.

    Conclusions:

    • Brain death significantly impairs both right and left ventricular systolic function.
    • The injury to the right ventricle is more severe and occurs earlier than that to the left ventricle post-brain death.
    • Brain death-induced right ventricular injury may contribute to clinical right ventricular failure observed after cardiac transplantation, warranting further investigation into the underlying mechanisms.