[Myocardial protection of the homograft. III - Evaluation of ventricular fibrillations with hypothermic coronary perfusion (author's transl)].
The homotransplanted heart is in severe failure in the immediate post-operative period, secondary to ischemia inherent to the technic of orthotopic transplantation. The present work was carried out to investigate if ventricular fibrillation followed by cold coronary perfusion could protect the homograft during implantation by evaluating the post-operative cardiac performance. In the control group, 7 hearts were excised, immediately immersed in physiological saline at 5 degrees C, and homotransplanted. In a second group of 4 grafts, ventricular fibrillation was induced and the coronary bed was perfused immediately with cold (5 degrees C) extracellular solution for a period of 10 minutes before orthotopic implantation. All animals were prepared at the end of surgery for hemodynamic studies to be carried out 3, 24 and 48 hours post-operatively in the resting state. In group I, the myocardial temperature dropped to 13.5 degrees C in 14.5 minutes. In group II, the hypothermia by perfusion was more rapid and deeper (11 degrees C within 10 minutes). Three hours post-operatively, cardiac function of group II was superior to that of group I as demonstrated by the increase of cardiac index (39%), stroke volume index (41%) mean systolic ejection rate index (44%), maximum systolic flow index (58%), maximum acceleration index (36%), stroke power index (88%), stroke work index (67%). Twenty-four and forty-eight hours post-operatively the cardio-vascular function improved in both groups but remained superior in group II. These results demonstrate that ventricular fibrillation followed by cold coronary perfusion increases protection of the homograft during the initial period of implantation.
D000818:Animals; D003326:Coronary Circulation; D004285:Dogs; D006324:Heart Arrest, Induced / Q000379:methods*; D016027:Heart Transplantation; D006439:Hemodynamics; D007036:Hypothermia, Induced / Q000379:methods*; D010477:Perfusion; D013696:Temperature; D014693:Ventricular Fibrillation / Q000503:physiopathology*
Protection myocardique de l'homogreffe. III - Evaluation de la fibrillation ventriculaire avec perfusion coronarienne hypothermique.