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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 December;40(6):811-6

CARDIAC PAPERS 

    ORIGINAL ARTICLES

Effect of Cel­sior and Uni­ver­sity of Wis­consin solu­tions on myo­car­dial metab­olism and func­tion ­after ­warm ­ischemia

Carrier M., Trudel S., Pelletier L. C.

From the Car­di­o­vas­colar Divi­sion Mon­treal ­Heart Insti­tute, Mon­treal, ­Quebec, ­Canada

Back­ground. ­Optimal pres­er­va­tion of ­donor ­hearts ­remains a sig­nif­i­cant con­cern ­during trans­plan­ta­tion. ­Organ ­shortage led to an ­increase in the use of dam­aged ­hearts.
­Methods. To ­study the ­effect of pres­er­va­tion solu­tions on ­recovery of myo­car­dial metab­olism and func­tion ­after ­warm ­ischemia, 10 ­dogs under­went 30 min­utes of ­warm ­global ­ischemia ­under car­di­o­pul­mo­nary ­bypass. The ani­mals ­were ­then admin­is­tered 1 ­liter of Cel­sior (5 ­dogs), an extra­cel­lular crys­tal­loid solu­tion or 1 ­liter of Uni­ver­sity of Wis­consin solu­tion (5 ­dogs), ­cooled at 4°C, fol­lowed by 60 min­utes of ­cold pres­er­va­tion and 30 min­utes of ­warm ­blood reper­fu­sion. Inter­sti­tial myo­car­dial pH and pO2 ­changes ­were meas­ured. The ­left ven­tricle dP/dt was meas­ured ­before and ­after the ­ischemic epi­sode, as ­where crea­tine ­kinase, tro­po­nine T and lac­tate ­serum ­levels.
­Results. ­Tissue pH aver­aged 6.9±0.1, 6.2±0.1, 6.7±0.1 and 6.8±0.1 ­before and ­after ­warm ­ischemia, fol­lowing the 60 min­utes of ­cold pres­er­va­tion and the reper­fu­sion ­period in ani­mals ­treated ­with the Cel­sior solu­tion, com­pared to 6.8±0.1, 6.4±0.1, 7±0.1 and 6.8±0.2 respec­tively in ­dogs ­treated ­with the Uni­ver­sity of Wis­consin solu­tion (p<0.05). ­Oxygen ten­sion in the myo­car­dium aver­aged 36±8 ­mmHg ­before ­warm ­ischemia and 59±31 ­mmHg ­after in ani­mals ­that ­received Cel­sior com­pared to 30±10 ­mmHg and 49±7 ­mmHg in ­dogs ­treated ­with Uni­ver­sity of Wis­consin (p>0.05). ­Global myo­car­dial func­tion ­decreased sig­nif­i­cantly fol­lowing reper­fu­sion com­pared to base­line in ­both ­groups of ani­mals. The ­serum ­levels of crea­tine ­kinase, tro­po­nine T and lac­tate ­increased sig­nif­i­cantly ­during the experi­ment ­although ­there was no sig­nif­i­cant dif­fer­ence ­between the 2 ­groups.
Con­clu­sion. ­Both pres­er­va­tion solu­tions (Cel­sior and Uni­ver­sity of Wis­consin) ­resulted in sub­op­timal ­recovery of myo­car­dial func­tion and metab­olism ­when admin­is­tered ­after a ­period of ­warm ­ischemia. Strat­e­gies to ­improve ­recovery of dam­aged ­donor ­hearts ­remain to be appro­pri­ately ­defined.

language: English


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