Perioperative Telemetric Monitoring in Pig-to-Baboon Heterotopic Thoracic Cardiac Xenotransplantation
Perioperative Telemetric Monitoring in Pig-to-Baboon Heterotopic Thoracic Cardiac Xenotransplantation
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DOI：
10.12659/aot.909522
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发表时间：
2018-07-20
影响因子：
1.1
通讯作者：
Abicht, Jan-Michael
中科院分区：
文献类型：
--
作者：
Laengin, Matthias;Panelli, Alessandro;Abicht, Jan-Michael
工作背景：由于异位胸部异种心脏移植术后有2颗独立跳动的心脏，围手术期监测和血流动力学管理具有挑战性。遥测允许连续监测供体和受体心脏的血流动力学参数。我们描述了我们的经验和报告的有效性的遥测系统在手术期间和之后surgery.Material/Methods：无线遥测发射器植入3狒狒接受猪供体心脏。从供体心脏评估左心室压力和ECG，而从受体评估主动脉压力和温度。结果：遥测血压低于有创血压。术中，移植物左心室中的探头测量到舒张末期压力为负。遥测可以简单地区分捐赠者和接受者的心率。遥测低估了体温。遥测监测有利于识别移植心律失常和体积demands.Conclusions：在异位胸部异种心脏移植，遥测植入物是有用的工具，连续监测动物的血流动力学参数，并区分供体和受体器官。准确性足以测量全身压力，但围手术期使用左心室舒张末期压作为移植物功能的替代参数是不可取的。通过遥测进行的温度测量并不反映身体核心温度。
Background: Perioperative monitoring and hemodynamic management after heterotopic thoracic cardiac xenotransplantation is challenging due to 2 independently beating hearts. Telemetry allows continuous monitoring of hemodynamic parameters of both the donor and recipient hearts. We describe our experience and report on the validity of a telemetric system during and after surgery.Material/Methods: Wireless telemetry transmitters were implanted in 3 baboons receiving porcine donor hearts. Left ventricular pressure and ECG were assessed from the donor heart, whereas aortic pressure and temperature were assessed from the recipient. Telemetric data were validated with invasive blood pressure measurements.Results: Telemetric blood pressure was lower than invasive blood pressure. Intraoperatively, the probe in the graft's left ventricle measured negative end-diastolic pressures. Telemetry allowed simple discrimination between donor's and recipient's heart rates. Body temperature was underestimated by telemetry. Telemetric monitoring facilitates recognition of graft arrhythmias and volume demand.Conclusions: In heterotopic thoracic cardiac xenotransplantation, telemetric implants are useful tools to continuously monitor the animals' hemodynamic parameters and to discriminate donor and recipient organs. Accuracy is sufficient for systemic pressure measurement, but perioperative use of left ventricular end-diastolic pressure as a surrogate parameter for graft function is not advisable. Temperature measurements by telemetry do not reflect body core temperature.