Function of adult pig hearts after 2 and 12 hours of cold cardioplegic preservation.
BACKGROUND
Most cardioplegic solutions have been developed using the classic Langendorf heart perfusion model, which only allows a short experimental follow-up. Our aim was to investigate hearts after prolonged storage by using a physiologic model including prolonged perfusion with normal, fresh blood.


METHODS
Sixteen hearts from 60-kg pigs were preserved with dextran-enriched (dextran-40, 35 g/L) St. Thomas' solution for 2 or 12 hours after which they were continuously reperfused for 12 hours with normal blood, supplied by a support pig. A flexible balloon, fixed to an artificial valve apparatus connected to a circuit system, was inserted in the left ventricle for obtaining measurements of hemodynamic performance.


RESULTS
During the first 3 to 4 hours of reperfusion there was no significant difference in left ventricular developed pressure, cardiac output, minute work output, or oxygen consumption between the two groups. After this time left ventricular developed pressure (p < 0.001), cardiac output (p < 0.01), minute work output (p < 0.01), and oxygen consumption were significantly lower in the 12-hour group. Coronary flow was higher (p < 0.01) and coronary vascular resistance lower (p < 0.01) during the first 5 to 6 hours of reperfusion in the 12-hour group. After 12 hours of reperfusion coronary vascular resistance was significantly higher (p < 0.01) in the 12-hour group.


CONCLUSIONS
High-degree and long-lasting coronary hyperemia at the beginning of reperfusion can be a sign of unsatisfactory preservation of the heart. This investigation shows the importance of reperfusion with normal blood and a long follow-up period after postischemic reperfusion when studying the effect of cardioplegic solutions.
Department of Cardiothoracic Surgery, University Hospital of Lund, Sweden.
A
A
Budrikis
R
R
Bolys
Q
Q
Liao
R
R
Ingemansson
T
T
Sjöberg
S
S
Steen
D000818:Animals; D001639:Bicarbonates / Q000627:therapeutic use; D001769:Blood; D002122:Calcium Chloride / Q000627:therapeutic use; D006328:Cardiac Catheterization; D002302:Cardiac Output; D002314:Cardioplegic Solutions / Q000627:therapeutic use*; D002404:Catheterization; D003326:Coronary Circulation; D015925:Cryopreservation; D003911:Dextrans / Q000627:therapeutic use; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D016027:Heart Transplantation / Q000502:physiology*; D006940:Hyperemia / Q000503:physiopathology; D008274:Magnesium / Q000627:therapeutic use; D009926:Organ Preservation; D010101:Oxygen Consumption; D010477:Perfusion; D010952:Plasma Substitutes / Q000627:therapeutic use; D011189:Potassium Chloride / Q000627:therapeutic use; D012965:Sodium Chloride / Q000627:therapeutic use; D013318:Stroke Volume; D013552:Swine; D013997:Time Factors; D014655:Vascular Resistance; D016277:Ventricular Function, Left; D017725:Ventricular Pressure
D001639:Bicarbonates; D002314:Cardioplegic Solutions; D003911:Dextrans; D010952:Plasma Substitutes; C041711:St. Thomas' Hospital cardioplegic solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D008274:Magnesium; D002122:Calcium Chloride