The relationship between myocardial temperature and recovery after experimental cardioplegic arrest

Fl, Rosenfeldt

doi:10.1016/s0022-5223(19)38954-8

Cited by 46 publications

(2 citation statements)

References 14 publications

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“…Is isovolumic ventricular pressure measured by balloon a reliable surrogate for contractility and does it reflect pumping capacity? This technique for assessing contractility is well established in the physiological literature both in rats, 27 in dogs in our laboratory 28 and elsewhere 20 and in human donor hearts. 17,19 The intraventricular balloon system is easy to set up and this can be done during reperfusion.…”

Section: Discussion Of Resultsmentioning

confidence: 98%

Combined Assessment of Functional and Metabolic Performance of Human Donor Hearts: Possible Application in Donation After Circulatory Death

Bhaskaran

Marasco

et al. 2020

Transplantation

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Background. Donation after circulatory death (DCD) represents an increasing source of organs. However, evaluating the suitability of DCD hearts for transplantation represents a challenge. Contractile function is the ultimate determinant of recovery. We developed a novel technique in an ex vivo rig for the measurement of contractility using intraventricular balloons. We compared this technique with the measurement of lactate metabolism, the current gold standard. Methods. Human DCD (n = 6) and donation after brain death (n = 6) hearts were preserved by perfusion with a cold oxygenated crystalloid solution for 4 h, transferred to a blood perfusion rig at 37 °C where balloons were inserted into the left (LV) and right (RV) ventricles to measure developed pressure (DP = systolic minus diastolic). Perfusate lactate levels were measured for metabolic assessment. Concordance between LVDP and lactate was assessed during 4 h using cutoffs for LVDP of 70 mm Hg and for lactate of 10 mmol/L. Results. Measurements of contractile function (LVDP) and metabolism (lactate levels) were deemed concordant in 7 hearts with either a high LVDP (mean 100 mm Hg) with low lactate (mean 6.7 mmol/L)) or a low LVDP (15 mm Hg) with high lactate (mean 17.3 mmol/). In the remaining 5 hearts, measurements were deemed discordant: 4 hearts had high LVDP (mean 124 mm Hg), despite high lactate levels 17.3 mmol/L) and 1 had low LVDP (54 mm Hg) but low lactate (6.9 mmol/L). Conclusions. The intraventricular balloon technique provides useful information regarding contractile recovery of donor hearts that if combined with lactate metabolism has potential application for the evaluation of DCD and marginal donation after brain death hearts before transplant.

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Section: Discussion Of Resultsmentioning

confidence: 98%

Combined Assessment of Functional and Metabolic Performance of Human Donor Hearts: Possible Application in Donation After Circulatory Death

Bhaskaran

Marasco

et al. 2020

Transplantation

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“…The subsequent insult is time dependent and may lead to irreversible damage of the myocardium [ 1]. With the realization that hypothermia reduces myocardial metabolic demands [1,4,[8][9][10][11], many cardiac surgeons consider cooling of the myocardium to be the predominant consideration for myocardial protection after electromechanical cardiac arrest. Efforts to rapidly achieve and maintain a cold myocardium during ischemia include moderate systemic hypothermia, careful application of topical cold saline or slush, and hypothermic coronary perfusion by way of the cross-clamped, proximal aorta.…”

Section: Discussionmentioning

confidence: 99%

Continuous warm blood cardioplegia: A randomized prospective clinical comparison

Curtis¹,

Nawarawong²,

Walls³

et al. 1996

Int J Angiol

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Myocardial Preservation During Open Heart Surgery

Lake

1985

Cardiovascular Anesthesia

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The relationship between myocardial temperature and recovery after experimental cardioplegic arrest

Cited by 46 publications

References 14 publications

Combined Assessment of Functional and Metabolic Performance of Human Donor Hearts: Possible Application in Donation After Circulatory Death

Combined Assessment of Functional and Metabolic Performance of Human Donor Hearts: Possible Application in Donation After Circulatory Death

Continuous warm blood cardioplegia: A randomized prospective clinical comparison

Myocardial Preservation During Open Heart Surgery

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