目的研究长时程心脏不停跳保存方法和技术。方法选用成年广西巴马小型猪 6头,麻醉成功后,取胸部正中切口,全身肝素化,不切开心包。先在头臂干插灌注管,后切断上腔静脉和左下肺静脉,用手协助排空左心室,用停跳液灌注心脏。摘取心脏后与灌注装置连接并用去白细胞和去血小板的稀释血液灌注心脏,使心脏恢复跳动(非工作心脏模型)。结果不停跳保存6例离体心脏8 h全部成功,保存期间灌注压没有上升。结论心脏空跳保存是可行的,保存的关键技术是减轻红细胞破坏、维持适宜的灌注压、左心室有效的减压和防止心脏水分丧失。
ObjectiveStudy on the methods and techniques of long term beating heart preservation. MethodSelected 6 adult Guangxi Bama miniature pigs, after the success of anesthesia, took the chest of the median incision, whole body heparinization, didn’t cut pericardium. First in the brachiocephalic trunk perfusion tube was inserted, and then the superior vena cava and the left inferior pulmonary vein were cut off, and then left ventricle was emptied with hand, and then the heart was perfused with cardioplegic solution. The heart was connected to the perfusion device after it was removed, and was perfused with diluted blood which white blood cells and platelets have been removed and beating recovery (non-working heart model). ResultsThe 6 isolated hearts were successfully preservated in a beating state for 8h. During preservation, perfusion pressure was not rising. ConclusionPreservation isolated heart in a beating state is feasible. Preservation of key technologies is to reduce the destruction of red blood cells, maintain appropriate perfusion pressure, the effective decompression of the left ventricle and to prevent the loss of heart water.