In vitro studies of human hearts
In vitro studies of human hearts
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DOI：
10.1016/j.athoracsur.2004.06.080
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发表时间：
2005-01-01
影响因子：
4.6
通讯作者：
Iaizzo, PA
中科院分区：
文献类型：
--
作者：
Hill, AJ;Laske, TG;Iaizzo, PA
背景。分离的哺乳动物心脏已被用于许多研究，这些研究在心脏生理学、药理学和外科方面取得了许多重要发现。已经描述了多种灌注方法，包括逆行和/或顺行流动以及晶体或血液灌注。此外，研究还利用了多种动物，包括：大鼠、家兔、豚鼠、犬和猪。本研究的目的是描述一种独特的分离心脏制备，利用不能移植的人类心脏，允许生理性灌注和心内膜成像。利用标准的心脏移植程序，12颗被认为不适合移植的人类心脏被移植到一个分离的心脏装置上。使用一种透明的、改良的Krebs-Henseleit缓冲液作为血液替代品，利用插入心腔的6.0 mm内窥镜摄像机进行心内膜成像。在Langendorff（逆行）和/或工作（生理）模式下灌注心脏。12颗心脏中有11颗在工作模式下达到了以下表现：左心室压力峰值为21.5至75.8 min Hg，平均为42.7±19.9 mm Hg。所有心脏都可以进行心内解剖成像，为正常和病理心内解剖以及生物医学装置与心脏的相互作用提供了独特的视角。我们描述了一种独特的分离心脏制备方法，我们成功地使11颗被认为无法移植的人类心脏复活，通过工作模式灌注它们，并进行心内解剖成像。这种方法为获得功能性人类心脏解剖图像和各种类型的独特生物医学评估提供了一种新的手段。
Background. Isolated mammalian hearts have been used in numerous studies that have led to many important discoveries in cardiac physiology, pharmacology, and surgery. Multiple methods of perfusion have been described including retrograde and/or antegrade flows and crystalloid or blood perfusates. Furthermore, multiple species have been utilized for such studies including the following: rat, rabbit, guinea pig, canine, and swine. The objective of this study was to describe a unique isolated heart preparation, utilizing human hearts not viable for transplant, which allows for physiologic perfusion and endocardial imaging.Methods. Utilizing standard cardiac transplantation procedures, 12 human hearts deemed not viable for transplant were explanted to an isolated heart apparatus. A clear, modified Krebs-Henseleit buffer was used as a blood substitute, which allowed for endocardial imaging utilizing 6.0 mm endoscopic video cameras inserted into the cardiac chambers. The hearts were perfused in Langendorff (retrograde) and/or working (physiologic) mode.Results. Eleven of 12 hearts achieved the following performance in working mode: peak left ventricular pressure of 21.5 to 75.8 min Hg, with an average of 42.7 +/- 19.9 mm Hg. Intracardiac anatomical imaging was possible in all hearts, providing unique views of normal and pathological endocardial anatomy as well as biomedical device-heart interactions.Conclusions. We have described a unique isolated heart preparation with which we have successfully reanimated 11 human hearts deemed not viable for transplant, perfused them by working mode, and performed intracardiac anatomical imaging. This approach provides a novel means for obtaining images of functional human cardiac anatomy and various types of unique biomedical assessments.