Effects of crystalloid, blood, and University of Wisconsin perfusates on weight, water content, and left ventricular compliance in an edema-prone, isolated porcine heart model.
Coronary perfusion with blood and cardioplegic solutions was examined in isolated, arrested, hypothermic porcine hearts. Myocardial water content, heart weight, and left ventricular diastolic pressure-volume curves were measured before and after coronary perfusion. Statistics were based on exponential curve fitting to pressure-volume data and analysis of variance. Thirty-two pig hearts were divided into five experimental groups and a control group; after control measurements, each experimental group underwent three successive coronary perfusions with 1 L of unmodified blood or a solution of controlled osmolarity, 150 mOsm/L (diluted Plegisol solution), 280 mOsm/L (Plegisol solution and albumin), 334 mOsm/L (University of Wisconsin solution), or 380 mOsm/L (Stanford solution). After each perfusion, measurements were repeated. All experiments were completed within 90 minutes. The first perfusion was delayed 20 minutes after excision of the heart to allow for instrumentation. Each experimental group demonstrated a statistically significant increase in heart weight and myocardial water content and a significant decrease in left ventricular compliance after perfusion. Changes were less pronounced with blood than crystalloids. Edema effects were minimized but not prevented by hyperosmolarity. University of Wisconsin solution appeared unique in minimizing progressive edema after the first perfusion. Over the 81 perfusions studied, changes in left ventricular compliance were linearly related to heart weight and water content. We conclude that in this model, in which edema sensitivity is increased by delayed perfusion and venous occlusion, edema is minimized but not eliminated by whole blood and University of Wisconsin solution. The model appears useful in assessing properties of cardioplegia vehicles intended for use in the injured myocardium.
Weng
Z C
ZC
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, N.Y. 10032.
Nicolosi
A C
AC
Detwiler
P W
PW
Hsu
D T
DT
Schierman
S W
SW
Goldstein
A H
AH
Spotnitz
H M
HM
D000241:Adenosine; D000493:Allopurinol; D000704:Analysis of Variance; D000818:Animals; D001790:Blood Physiological Phenomena; D001794:Blood Pressure / Q000187:drug effects; D001834:Body Water; D002314:Cardioplegic Solutions / Q000009:adverse effects / Q000494:pharmacology*; D004489:Edema, Cardiac / Q000139:chemically induced / Q000517:prevention & control; D005978:Glutathione; D006321:Heart / Q000033:anatomy & histology / Q000187:drug effects*; D066298:In Vitro Techniques; D007328:Insulin; D008954:Models, Biological; D009206:Myocardium / Q000737:chemistry; D019188:Organ Preservation Solutions; D010477:Perfusion / Q000379:methods; D011188:Potassium / Q000009:adverse effects / Q000494:pharmacology; D017680:Potassium Compounds; D011887:Raffinose; D012996:Solutions / Q000009:adverse effects / Q000494:pharmacology*; D013552:Swine; D016277:Ventricular Function, Left / Q000187:drug effects
D002314:Cardioplegic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; D017680:Potassium Compounds; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; C018369:potassium cardioplegic solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; D011188:Potassium