使用被动左心房加压和被动后负荷进行心脏负载,以评估移植
George Olverson1, Manuela Lopera Higuita2, Maya Bolger-Chen2
1Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School.
Journal of visualized experiments : JoVE
|August 19, 2024
概括
这项研究引入了一种新的方法,用于在机器输液过程中评估心脏移植,使用左心室负荷. 这种技术可以客观地评估心脏功能,改善移植结果.
科学领域:
- 心血管外科心血管外科
- 器官移植 器官移植
- 生物医学工程 生物医学工程
背景情况:
- 常温机器输液 (NMP) 对于移植器官的保存至关重要.
- 目前的NMP移植评估依赖于有限的代谢趋势,缺乏客观的功能评估.
- 来自左心室负荷的血液动力学测量为移植评估提供了潜在的客观参数.
研究的目的:
- 开发一种有效的方法,将左心室负荷纳入已建立的兰登多夫 perfusion 系统.
- 为了证明被动左心房加压对于心脏负荷的可行性.
- 在输液过程中捕获功能性心脏指标,以改善移植评估.
主要方法:
- 修改了Langendorff perfusion系统,增加了一个额外的储来增加装载能力.
- 实施被动左心房加压,以控制心脏负荷.
- 集成一个被动的Windkessel后负载,以增强腹输液.
- 功能指标的测量:左心室脉冲压,收缩性和放松性.
主要成果:
- 成功地将载荷能力纳入标准的兰登多夫系统.
- 证明了被动左心房加压对于心脏负荷的可行性.
- 在心脏负荷期间捕获关键功能指标的能力.
- 在长时间保存 (>6小时) 后识别心脏移植缺陷.
结论:
- 开发的协议提供了一种有效和简单的方法,用于评估NMP期间的心脏移植.
- 被动左心房加压是 perfusion 系统中心脏负荷的可行方法.
- 这种方法可以对心脏移植进行客观的功能评估,从而有可能提高移植成功率.
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