Surgical technique for explantation of a functioning cardiopulmonary complex in an experiment

M. Zhulkov, I. Zykov, A. G. Makaev, A. Protopopov, M. Murtazaliev, F. Kosimov, A. Tarkova, A. D. Limansky, Ya. M. Smirnov, H. Agaeva, O. Frykina, D. A. Sirota
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Abstract

Objective: to develop and approve the surgical technique for explantation of a functioning cardiopulmonary complex under normothermic autoperfusion.Materials and methods. Landrace pigs were used as the experimental model for a series of acute experiments (n = 10). During the experiment, invasive pressure in the cavities of the heart and main arteries, blood gas composition, and myocardial contractility were monitored. The functioning cardiopulmonary complex was explanted through a median sternotomy. The explanted complex was conditioned at 37–38 °C for 6 hours.Results. In the course of a series of experiments, it was shown that stable operation of the isolated heart-lung complex ex vivo for 6 hours was fundamentally possible provided that the parameters of the basic homeostasis constants are maintained. The technological solutions used made it possible to ensure safe hemodynamic and anatomical isolation of the working cardiopulmonary complex.Conclusion. The developed protocol for isolating a functioning cardiopulmonary complex allows to provide stable graft function for 6 hours under normothermic autoperfusion. Implementation of this concept in the development of transport systems would significantly facilitate their design and eliminate the use of expensive components. This would contribute to widespread introduction into clinical practice.
在实验中剥离功能心肺复合体的手术技术
目的:开发并批准在常温自灌注条件下切除功能正常的心肺复合体的手术技术。以陆地猪为实验模型,进行一系列急性实验(n = 10)。在实验过程中,监测心脏和主要动脉腔内的侵入压力、血气成分和心肌收缩力。通过胸骨正中切口取出功能正常的心肺复合体。取出的复合体在 37-38 °C条件下放置 6 小时。在一系列实验过程中,结果表明,只要保持基本的平衡常量参数,离体心肺复合体在体外稳定运行 6 小时是完全可能的。所采用的技术解决方案可确保安全地从血液动力学和解剖学角度分离工作中的心肺复合体。所制定的隔离心肺功能复合体的方案可在常温自灌注条件下提供 6 小时稳定的移植物功能。在运输系统的开发过程中采用这一概念将大大方便其设计,并避免使用昂贵的组件。这将有助于广泛应用于临床实践。
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