Abstract
Objective: 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.
| Original language | English |
|---|---|
| Pages (from-to) | 69-76 |
| Number of pages | 8 |
| Journal | European Journal of Cardio-thoracic Surgery |
| Volume | 35 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2009 |
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Keywords
- Antegrade perfusion
- Empty-beating
- Energy metabolism
- Hypertrophied heart
- Myocardial oxygenation
- Retrograde perfusion
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
Cite this
Alternate antegrade/retrograde perfusion : an effective technique to preserve hypertrophied hearts during valvular surgery. / Wang, Jian; Liu, Hongyu; Salerno, Tomas; Tomanek, Boguslaw; Summers, Randy; Deslauriers, Roxanne; Arora, Rakesh C.; Tian, Ganghong.
In: European Journal of Cardio-thoracic Surgery, Vol. 35, No. 1, 01.01.2009, p. 69-76.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Alternate antegrade/retrograde perfusion
T2 - an effective technique to preserve hypertrophied hearts during valvular surgery
AU - Wang, Jian
AU - Liu, Hongyu
AU - Salerno, Tomas
AU - Tomanek, Boguslaw
AU - Summers, Randy
AU - Deslauriers, Roxanne
AU - Arora, Rakesh C.
AU - Tian, Ganghong
PY - 2009/1/1
Y1 - 2009/1/1
N2 - Objective: 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.
AB - Objective: 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.
KW - Antegrade perfusion
KW - Empty-beating
KW - Energy metabolism
KW - Hypertrophied heart
KW - Myocardial oxygenation
KW - Retrograde perfusion
UR - http://www.scopus.com/inward/record.url?scp=57549084827&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57549084827&partnerID=8YFLogxK
U2 - 10.1016/j.ejcts.2008.10.015
DO - 10.1016/j.ejcts.2008.10.015
M3 - Article
VL - 35
SP - 69
EP - 76
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 1
ER -