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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 504-513, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
ZC Weng, AC Nicolosi, PW Detwiler, DT Hsu, SW Schierman, AH Goldstein and HM Spotnitz
Coronary perfusion with blood and cardioplegic solutions was examined in
isolated, arrested, hypothermic porcine hearts. Myocardial water content,
heart weight, and left ventricular diastolic pressure-volume curves were
measured before and after coronary perfusion. Statistics were based on
exponential curve fitting to pressure-volume data and analysis of variance.
Thirty-two pig hearts were divided into five experimental groups and a
control group; after control measurements, each experimental group
underwent three successive coronary perfusions with 1 L of unmodified blood
or a solution of controlled osmolarity, 150 mOsm/L (diluted Plegisol
solution), 280 mOsm/L (Plegisol solution and albumin), 334 mOsm/L
(University of Wisconsin solution), or 380 mOsm/L (Stanford solution).
After each perfusion, measurements were repeated. All experiments were
completed within 90 minutes. The first perfusion was delayed 20 minutes
after excision of the heart to allow for instrumentation. Each experimental
group demonstrated a statistically significant increase in heart weight and
myocardial water content and a significant decrease in left ventricular
compliance after perfusion. Changes were less pronounced with blood than
crystalloids. Edema effects were minimized but not prevented by
hyperosmolarity. University of Wisconsin solution appeared unique in
minimizing progressive edema after the first perfusion. Over the 81
perfusions studied, changes in left ventricular compliance were linearly
related to heart weight and water content. We conclude that in this model,
in which edema sensitivity is increased by delayed perfusion and venous
occlusion, edema is minimized but not eliminated by whole blood and
University of Wisconsin solution. The model appears useful in assessing
properties of cardioplegia vehicles intended for use in the injured
myocardium.
ARTICLES
Effects of crystalloid, blood, and University of Wisconsin perfusates on weight, water content, and left ventricular compliance in an edema- prone, isolated porcine heart model
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, N.Y. 10032.
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