In vitro studies of human hearts.
BACKGROUND
Isolated mammalian hearts have been used in numerous studies that have led to many important discoveries in cardiac physiology, pharmacology, and surgery. Multiple methods of perfusion have been described including retrograde and/or antegrade flows and crystalloid or blood perfusates. Furthermore, multiple species have been utilized for such studies including the following: rat, rabbit, guinea pig, canine, and swine. The objective of this study was to describe a unique isolated heart preparation, utilizing human hearts not viable for transplant, which allows for physiologic perfusion and endocardial imaging.


METHODS
Utilizing standard cardiac transplantation procedures, 12 human hearts deemed not viable for transplant were explanted to an isolated heart apparatus. A clear, modified Krebs-Henseleit buffer was used as a blood substitute, which allowed for endocardial imaging utilizing 6.0 mm endoscopic video cameras inserted into the cardiac chambers. The hearts were perfused in Langendorff (retrograde) and/or working (physiologic) mode.


RESULTS
Eleven of 12 hearts achieved the following performance in working mode: peak left ventricular pressure of 21.5 to 75.8 mm Hg, with an average of 42.7 +/- 19.9 mm Hg. Intracardiac anatomical imaging was possible in all hearts, providing unique views of normal and pathological endocardial anatomy as well as biomedical device-heart interactions.


CONCLUSIONS
We have described a unique isolated heart preparation with which we have successfully reanimated 11 human hearts deemed not viable for transplant, perfused them by working mode, and performed intracardiac anatomical imaging. This approach provides a novel means for obtaining images of functional human cardiac anatomy and various types of unique biomedical assessments.
Hill
Alexander J
AJ
Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA.
Laske
Timothy G
TG
Coles
James A
JA
Sigg
Daniel C
DC
Skadsberg
Nicholas D
ND
Vincent
Sarah A
SA
Soule
Charles L
CL
Gallagher
William J
WJ
Iaizzo
Paul A
PA
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002316:Cardiotonic Agents / Q000494:pharmacology; D003470:Culture Media; D004280:Dobutamine / Q000494:pharmacology; D004554:Electric Countershock; D004562:Electrocardiography; D004837:Epinephrine / Q000494:pharmacology; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006321:Heart / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009924:Organ Culture Techniques / Q000295:instrumentation / Q000379:methods*; D010477:Perfusion; D020858:Tissue and Organ Harvesting
D002316:Cardiotonic Agents; D003470:Culture Media; D004280:Dobutamine; D004837:Epinephrine