Keeping the heart empty and beating improves preservation of hypertrophied hearts for valve surgery Jian Wang, MD, Hongyu Liu, MD, PhD, Bo Xiang, DDS,

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Presentation transcript:

Keeping the heart empty and beating improves preservation of hypertrophied hearts for valve surgery Jian Wang, MD, Hongyu Liu, MD, PhD, Bo Xiang, DDS, Gang Li, MD, PhD, Marco Gruwel, PhD, Michael Jackson, PhD, Boguslaw Tomanek, PhD, Tomas A. Salerno, MD, Roxanne Deslauriers, PhD, Ganghong Tian, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 132, Issue 6, Pages 1314-1320 (December 2006) DOI: 10.1016/j.jtcvs.2006.07.010 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Schematic illustration of the experimental protocol. CP, Control perfusion; NNSP, normothermic normokalemic simultaneous perfusion; NHSP, normothermic hyperkalemic simultaneous perfusion; LAD, left anterior descending coronary artery. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1314-1320DOI: (10.1016/j.jtcvs.2006.07.010) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 The upper panel shows a representative intramyocardial pressure record obtained from a heart subjected to NNSP and NHSP. The lower panel shows average intramyocardial hydrostatic pressures obtained from NNSP hearts and NHSP hearts. NNSP, normothermic normokalemic simultaneous perfusion; NHSP, normothermic hyperkalemic simultaneous perfusion. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1314-1320DOI: (10.1016/j.jtcvs.2006.07.010) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Comparison of the volumes of extracellular (upper panel) and intracellular (lower panel) compartments between the NNSP hearts and NHSP hearts. NHSP, normothermic hyperkalemic simultaneous perfusion; NNSP, normothermic normokalemic simultaneous perfusion; CP, Control perfusion. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1314-1320DOI: (10.1016/j.jtcvs.2006.07.010) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Representative 31P MR spectra obtained from an NNSP heart and an NHSP heart. A significant increase in inorganic phosphate (Pi) and a decrease in PCr were observed in the NNSP heart when the LAD flow was reduced to 50% of its control level (left column). No significant changes in ATP, PCr, or Pi were observed in the NHSP heart (right column). LAD, left anterior descending coronary artery; ATP, adenosine triphosphate; PPM, parts per million; NNSP, normothermic normokalemic simultaneous perfusion; NHSP, normothermic hyperkalemic simultaneous perfusion. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1314-1320DOI: (10.1016/j.jtcvs.2006.07.010) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Comparison of myocardial PCr (upper panel) and ATP (lower panel) levels between the NNSP hearts and NHSP hearts with differential LAD perfusion flow. NNSP, normothermic normokalemic simultaneous perfusion; NHSP, normothermic hyperkalemic simultaneous perfusion; LAD, left anterior descending coronary artery; ATP, adenosine triphosphate. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1314-1320DOI: (10.1016/j.jtcvs.2006.07.010) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions