Assessment of left ventricular compliance during heart preservation

Douglas F Larson, Lance B. Gatewood, Mark Bowers, Gulshan Sethi, Jack G. Copeland

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

There is critical need for a greater number of donor hearts for transplantation. The demand can be relieved, in part, by an extension of preservation time. This necessitates new methods of preservation and development of means to assess the functional condition of the preserved heart. We report a heart-preservation system designed for long-term preservation support and discuss issues specifically related to extended heart preservation. This article presents methodology to assess ventricular compliance and to quantify coronary flow distribution during the use of microperfusion preservation. Ventricular adenosine triphosphate (ATP) concentrations are directly related to the immediate post-preservation function: however, direct measurement of ATP is not clinically available. Based on the premise that ventricular compliance relates directly to the ventricular ATP concentrations, we performed sequential ventricular compliance measurements using a simple left ventricular balloon during a 24 h preservation period. A porcine heart model was employed using a continuous, hypothermic, antegrade, microperfusion system for 24 h and measurements were made at specific intervals during the preservation time. The compliance measurements were ascertained by pressure-volume curves using a flaccid balloon inserted into the left ventricle through the mitral valve. In addition, to assess microvascular function during the preservation interval, regional coronary flow measurements were performed using a microsphere technique. We report that after 12 h of preservation there was a twofold reduction in ventricular compliance which decreased further by fivefold at 18 h. In contrast, there was a time-dependent decrease in left ventricular coronary flow, especially with the left-ventricular subendocardial region significantly decreasing by 50% at 12 h. In conclusion, a simple ventricular-compliance balloon provided a direct measurement of ventricular compliance of the preserved heart which may provide an indirect estimate of the ventricular high-energy phosphates of the preserved heart prior to transplantation.

Original languageEnglish (US)
Pages (from-to)67-75
Number of pages9
JournalPerfusion
Volume13
Issue number1
StatePublished - 1998

Fingerprint

Compliance
Balloons
Adenosine Triphosphate
Flow measurement
Heart Transplantation
Microspheres
Mitral Valve
Heart Ventricles
Phosphates
Swine
energy
Transplantation
demand
Pressure
methodology
time

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Larson, D. F., Gatewood, L. B., Bowers, M., Sethi, G., & Copeland, J. G. (1998). Assessment of left ventricular compliance during heart preservation. Perfusion, 13(1), 67-75.

Assessment of left ventricular compliance during heart preservation. / Larson, Douglas F; Gatewood, Lance B.; Bowers, Mark; Sethi, Gulshan; Copeland, Jack G.

In: Perfusion, Vol. 13, No. 1, 1998, p. 67-75.

Research output: Contribution to journalArticle

Larson, DF, Gatewood, LB, Bowers, M, Sethi, G & Copeland, JG 1998, 'Assessment of left ventricular compliance during heart preservation', Perfusion, vol. 13, no. 1, pp. 67-75.
Larson DF, Gatewood LB, Bowers M, Sethi G, Copeland JG. Assessment of left ventricular compliance during heart preservation. Perfusion. 1998;13(1):67-75.
Larson, Douglas F ; Gatewood, Lance B. ; Bowers, Mark ; Sethi, Gulshan ; Copeland, Jack G. / Assessment of left ventricular compliance during heart preservation. In: Perfusion. 1998 ; Vol. 13, No. 1. pp. 67-75.
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