Heart preservation in HTK solution: role of coronary vasculature in recovery of cardiac function Yuhei Saitoh, MD, PhD, Michio Hashimoto, PhD, Kwansong.

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Presentation transcript:

Heart preservation in HTK solution: role of coronary vasculature in recovery of cardiac function Yuhei Saitoh, MD, PhD, Michio Hashimoto, PhD, Kwansong Ku, MD, PhD, Seikon Kin, MD, PhD, Seishi Nosaka, MD, PhD, Sumio Masumura, PhD, Kengo Nakayama, MD, PhD The Annals of Thoracic Surgery Volume 69, Issue 1, Pages 107-112 (January 2000) DOI: 10.1016/S0003-4975(99)01190-X

Fig 1 In the experimental protocol of functional cardiac recovery hearts were excised and mounted on a Langendorff apparatus. They were perfused for 3 minutes Langendorff mode (1) and for 2 minute working mode (2). They were arrested and stored for 8 hours in UW or HTK solution at 4°C. Following cold storage, they were reperfused for 15 minutes Langendorff mode (3) and 25 minutes working mode (4). The Annals of Thoracic Surgery 2000 69, 107-112DOI: (10.1016/S0003-4975(99)01190-X)

Fig 2 In the experimental protocol of mechanical function of coronary endothelium the hearts were excised and mounted on a Langendorff apparatus. They were perfused for 5 minutes Langendorff perfusion. They were arrested and stored for 8 hours in UW or HTK solution at 4°C. Following storage, they were reperfused for 40 minutes Langendorff perfusion. The left main trunks were dissected out and the endothelial function was examined at four stages; (1) before flushing (group 1) and before storage following cardiac arrest with each solution (flush injury: group 2 and 3); (2) just after storage without reperfusion (flush/storage injury: group 4 and 5); and (3) after storage with reperfusion (flush/storage/reperfusion injury: group 6 and 7). The Annals of Thoracic Surgery 2000 69, 107-112DOI: (10.1016/S0003-4975(99)01190-X)

Fig 3 The functional cardiac recovery of AF, CF, CO, RPP, and LV dp/dt after 8 hours of preservation was significantly better in the group stored in HTK than in UW (∗p < 0.05). (AF = aortic flow; CF = coronary flow; CO = cardiac output; RPP = rate pressure product; LV = left ventricle.) The Annals of Thoracic Surgery 2000 69, 107-112DOI: (10.1016/S0003-4975(99)01190-X)

Fig 4 The total adenine nucleotides (TAN) values (A) and the ATP/ADP ratios (B) in the myocardium of HTK group were significantly higher than those of the UW group (∗p < 0.05) following storage. (ATP = adenosine triphosphate; ADP = adenosine diphosphate.) The Annals of Thoracic Surgery 2000 69, 107-112DOI: (10.1016/S0003-4975(99)01190-X)

Fig 5 There were no significant differences between the HTK and UW groups of isolated coronary arteries in the KCL-induced (A) and prostaglandin F2α-induced (B) maximal contractions at any of the stages. (KCl = potassium chloride; PGF2α = prostaglandin F2α.) The Annals of Thoracic Surgery 2000 69, 107-112DOI: (10.1016/S0003-4975(99)01190-X)

Fig 6 The maximal relaxation responses to ACh after reperfusion of isolated coronary arteries was significantly improved in the HTK group compared with UW group (∗p < 0.05) (A). The relaxation responses to SNP in the HTK group was also well preserved after reperfusion (B). The ED50 values for ACh were similar at all stages in the HTK and UW groups (C). (ACh = acetylcholine; SNP = sodium nitroprusside.) The Annals of Thoracic Surgery 2000 69, 107-112DOI: (10.1016/S0003-4975(99)01190-X)