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The Journal of Thoracic and Cardiovascular Surgery, Vol 81, 440-449, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
DM Bethencourt and H Laks
The development of myocardial edema and the changes in compliance during
long-term preservation and reperfusion of 10 dog hearts were studied. Krebs
solution, modified by the addition of potassium chloride (20 mEq/L), was
used for 24 hours of low-pressure perfusion (15 mm Hg), at 4 degrees C. The
hearts then were reperfused with the use of a support dog. Gravimetric
heart water of myocardial biopsy tissue increased from control values of
78.0 +/- 0.8 to 82.8 +/- 0.6 ml/100 gm at 1 hour (p less than 0.01) and to
84.2 +/- 0.3 ml/100 gm after 24 hours of preservation (p less than 0.05
compared to 1 hour). After reperfusion, heart water decreased to 82.8 +/-
0.3 ml/100 gm (p less than 0.05). Passive compliance during preservation,
obtained using an inflatable intraventricular balloon, decreased from 1.49
+/- 0.03 ml/mm Hg at 1 hour to 0.65 +/- 0.14 ml/mm Hg at 24 hours (p less
than 0.05). High-energy phosphate levels were unchanged at 1 and 24 hours
of preservation. Light and electron microscopy at 24 hours of preservation
showed marked pericapillary edema and excellent preservation of
intracellular structures. During reperfusion, ventricular function curves
and dp/dt (2,841 +/- 581 mm Hg/sec) were comparable to previously reported
control values. Passive compliance at 24 hours correlated with the
diastolic compliance during reperfusion (p less than 0.01). The change in
passive compliance during preservation also correlated with the change in
coronary vascular resistance, a previously reported index of myocardial
viability (p less than 0.05). This study has shown that the change in
passive compliance of the heart during perfusion correlates with the
adequacy of myocardial preservation and provides an additional index of
preserved heart viability.
ARTICLES
Importance of edema and compliance changes during 24 hours of preservation of the dog heart
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