Alternate antegrade/retrograde perfusion: an effective technique to preserve hypertrophied hearts during valvular surgery

Download
  1. Get@NRC: Alternate antegrade/retrograde perfusion: an effective technique to preserve hypertrophied hearts during valvular surgery (Opens in a new window)
DOIResolve DOI: http://doi.org/10.1016/j.ejcts.2008.10.015
AuthorSearch for: ; Search for: ; Search for: ; Search for: ; Search for: ; Search for: ; Search for: ; Search for:
TypeArticle
Journal titleEuropean Journal of Cardiothoracic Surgery
Volume35
Issue1
Pages6976; # of pages: 8
SubjectHypertrophied heart; Antegrade perfusion; Retrograde perfusion; Empty-beating; Energy metabolism; Myocardial oxygenation
AbstractObjective: Continuous antegrade perfusion (AP) may interfere with surgical precision. Continuous retrograde perfusion (RP), on the other hand, cannot sustain the empty-beating hypertrophied hearts. Therefore, alternate antegrade/retrograde perfusion (AA/RP) may be a rational technique to preserve the hypertrophied hearts. This study is to determine whether AA/RP could maintain myocardial energy metabolism, oxygenation, and contractile function of the empty-beating hypertrophied hearts. Methods: Sixteen hypertrophied pig hearts were divided into four groups (n = 4 per group). Group I and II underwent an 80-min AA/RP (four 10-min APs and four 10-min RPs), followed by a 20-min reperfusion. Group III and IV were subjected to an 80-min AP and 20-min reperfusion and used as a control. Energy metabolism was evaluated in group I and III using magnetic resonance spectroscopy. Myocardial oxygenation (MO) was assessed in group II and IV using near infrared spectroscopic imaging. Results: During 80-min AA/RP, four episodes of RP resulted in a significant decrease in myocardial phosphocreatine (PCr) and MO. The subsequent AP, however, resulted in complete recovery of the parameters. Moreover, myocardial adenosine triphosphate (ATP) remained at a normal level throughout the 80-min AA/RP. As expected, hearts in groups III and IV showed normal level of myocardial PCr, ATP, and MO throughout protocol. Finally, hearts in all four groups showed similar contractile function during reperfusion. Conclusions: AA/RP with four 10-min intervals of AP and RP sustained normal myocardial energy metabolism, oxygenation, and contractile function of empty-beating hypertrophied hearts. We conclude that AA/RP is an effective technique for preservation of empty-beating hypertrophied hearts during valvular surgery.
Publication date
LanguageEnglish
AffiliationNational Research Council Canada; NRC Institute for Biodiagnostics
NoteErratum published in Volume 39, Issue 5, page 615, 2011. DOI: 10.1016/j.ejcts.2011.01.061
Peer reviewedNo
NRC number2428
NPARC number9148335
Export citationExport as RIS
Report a correctionReport a correction
Record identifierb863a389-b444-4aff-88b7-c094376ee6a5
Record created2009-06-25
Record modified2016-05-09
Bookmark and share
  • Share this page with Facebook (Opens in a new window)
  • Share this page with Twitter (Opens in a new window)
  • Share this page with Google+ (Opens in a new window)
  • Share this page with Delicious (Opens in a new window)