Successful long-term preservation of the neonatal heart with a modified intracellular solution
| Autor: | Davis C. Drinkwater, Hillel Laks, Elias Kaczer, Sunita Bhuta, Michael A. Breda, Paul Chang, Jeffrey L. Sebastian, Betty Ho |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Pulmonary and Respiratory Medicine
Resuscitation medicine.medical_specialty Adenosine Time Factors Swine Allopurinol medicine.medical_treatment Organ Preservation Solutions Ischemia Myocardial Reperfusion Injury Sodium Chloride Potassium Chloride Raffinose Biopsy medicine Animals Insulin Mannitol Viaspan Cardioplegic Solutions Saline Stroke medicine.diagnostic_test business.industry Myocardium Heart Organ Preservation medicine.disease Glutathione Surgery Solutions Transplantation Bicarbonates Microscopy Electron Glucose Animals Newborn Anesthesia Heart Transplantation Cardiology and Cardiovascular Medicine business Intracellular |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 104:139-150 |
| ISSN: | 0022-5223 |
| Popis: | Current methods of myocardial preservation for transplantation are suboptimal. A newly developed intracellular cardioplegic and storage solution (modified University of Wisconsin solution, group 1) was compared in a randomized, blinded fashion with our present clinical protocol, Stanford cardioplegic solution and saline storage (group 2) in an isolated neonatal pig model. After arrest and storage for 12 hours at 4 degrees C, biopsy specimens were taken from six group 1 hearts and five group 2 hearts for examination under an electron microscope and assessment of high-energy phosphate levels and water content. The remainder (group 1, n = 7; group 2, n = 6) were reperfused with blood for 50 minutes, after which function curves were obtained at left ventricular end-diastolic pressures of 3 to 12 mm Hg and biopsy tissue was taken. Eight control hearts (group 3) were cannulated in situ and perfused on the circuit without arrest or intervening ischemia. Stroke and minute work index curves were approximately threefold and fivefold higher for group 1 (modified University of Wisconsin solution) than for group 2 (Stanford), respectively (p less than 0.01). The hearts preserved with University of Wisconsin solution did not differ in function from unpreserved control hearts (group 3). High-energy phosphate levels were better maintained in group 1 than group 2 (p less than 0.05), and water content was lower (p less than 0.01). Semiquantitative grading of electron micrographs paralleled the functional and biochemical results.Modified University of Wisconsin intracellular solution provides markedly better heart preservation than conventionally used cardioplegic and storage solutions. |
| Databáze: | OpenAIRE |
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