Influence of transmyocardial laser revascularization (TMLR) on regional cardiac function and metabolism in an isolated hemoperfused working pig heart

Autor: I. Ast, Wolfgang Konertz, D. Modersohn, S. Holinski, S. Eddicks
Rok vydání: 2002
Předmět:
Cardiac function curve
medicine.medical_specialty
Pig heart
Swine
medicine.medical_treatment
030232 urology & nephrology
Biomedical Engineering
Ischemia
Myocardial Ischemia
Medicine (miscellaneous)
Bioengineering
030204 cardiovascular system & hematology
Revascularization
Sensitivity and Specificity
Statistics
Nonparametric
Ventricular Function
Left
Biomaterials
03 medical and health sciences
Random Allocation
0302 clinical medicine
Reference Values
Internal medicine
medicine
Myocardial Revascularization
Animals
Probability
Analysis of Variance
business.industry
Hemodynamics
General Medicine
medicine.disease
Myocardial Contraction
Disease Models
Animal
Coronary occlusion
Heart Function Tests
Cardiology
Ventricular pressure
Heart Arrest
Induced
Transmyocardial laser revascularization
Female
Laser Therapy
business
Perfusion
Zdroj: The International journal of artificial organs. 25(11)
ISSN: 0391-3988
Popis: The mechanism of an indirect revascularization in ischemic myocardium by transmyocardial laser revascularization (TMLR) is not yet fully understood. An improvement of clinical symptoms caused by TMLR is reported in many clinical trials with patients in which a direct revascularization is not possible. An increase of myocardial perfusion through laser channels is doubtful, because the myocardial pressure in the wall is higher than in the cavum. Therefore we measured the local cardiac function (intramyocardial pressure, wall thickness, pressure-length curves) and acute metabolic changes (tissue lactate content, tissue pO2) in ischemic and non-ischemic regions before and after TMLR in isolated hemoperfused pig hearts. An isolated heart was chosen because it enabled us to separate coronary flow from flow through ventricular channels. The ischemia was induced by coronary occlusion or microembolization (eight hearts each). It should be noted that microembolization leads to conditions which are more comparable with those found in patients selected for TMLR. In the isolated working heart, the coronary perfusion can be controlled independently from perfusion through the ventricular cavum. Under the ischemic conditions mentioned above, we observed that the intramyocardial pressure in the ischemic region decreased below the left ventricular pressure, so one premise for indirect perfusion was met. TMLR after microembolization led to a significant improvement of regional cardiac work and the tissue oxygen pressure. These acute effects demonstrate the possibility of functional and metabolic amelioration by TMLR after ischemia induced by microembolization in an isolated hemoperfused pig heart.
Databáze: OpenAIRE
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