OUTCOMES FOLLOWING HIGH RISK SURGERY PROVIDED AS AN ALTERNATIVE TO TRANSPLANT IN PATIENTS WITH END-STAGE HEART DISEASE

Abstract

minutes, p1⁄40.39) prior to IR. Coronary blood flow (6.41⁄4910 21, 6.91⁄4871 31, 7.41⁄4868 34 mL/min, p1⁄40.60) and coronary sinus lactate concentration (6.41⁄41.6 0.5, 6.91⁄41.3 0.1, 7.41⁄41.9 0.1 umol/L, p1⁄40.25) were comparable among treatment groups during IR. The pH of the cardioplegic solution delivered during the 3-minute IR period significantly impacted the development of myocardial edema (6.41⁄415.2 2.9, 6.91⁄48.5 1.2, 7.41⁄410.1 0.9 grams/hour weight gain, p1⁄40.03) and the recovery of indexed cardiac output (6.41⁄43.1 0.8, 6.91⁄48.4 1.8, 7.41⁄46.1 0.9 mL/minute/gram, p1⁄40.04) during subsequent EVHP. CONCLUSION: IR of DCD hearts with a profoundly acidic (pH1⁄46.4) cardioplegic solution is associated with the development of myocardial edema and impaired functional recovery during EVHP, while IR under moderately acidic (pH1⁄46.9) conditions appears to be protective.