In order to assess the transvalvular gradient of a Chinese-made Jiuling solid pyrolytic carbon bileaflet heart valve prosthesis, we determined its hydrodynamics in the laboratory and then measured the hemodynamic performance in the animals and patiens. The Jiuling prosthesis was tested in a pulsatile flow simulator in the aortic position. Six sheep subjected to mitral replacement with 21 mm Jiuling prosthesis were measured by open cardiac catheterization intraoperatively. Doppler echocardiography and open cardiac catheterization under dobutamine stress were performed in two sheep 60 months after implantation. Clinically, 14 cases of aortic valve and 10 cases of mitral valve in the patients who underwent valve replacement with Jiuling heart valve prosthesis were measured by open cardiac catheterization and Doppler echocardiopgraphy. The results showed that Juiling heart valve prosthesis had lower mean transvalvular gradient (below 10 mmHg) at any given tissue annulus diameter. In animal experiments, the transvalvular gradients of 6 sheep were 5.2 +/- 1.7 mmHg intraoperatively, and of 2 sheep 60 months after implantation were 6.1 +/- 0.3 mmHg by catheterization. In patients, the mean transvalvular gradients in the aortic position measured by means of catheterization and echocardiography were 6.26-4.10 mmHg and 9.42-7.48 mmHg; the gradients in the mitral position were 2.10-1.9 mmHg and 5.281-4.10 mmHg respectively. The above results demonstrate that Jiuling valve prosthesis has excellent hemodynamic performance.
Adult ; Animals ; Aortic Valve ; surgery ; Biocompatible Materials ; Carbon ; chemistry ; Echocardiography ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Hemodynamics ; physiology ; Humans ; Male ; Mitral Valve ; surgery ; Prosthesis Design ; Sheep ; Ventricular Function, Left

OBJECTIVETo investigate the fluctuations in arterial leukocyte phospholipase D (PLD) activity during the perioperative period of open heart surgery under cardiopulmonary bypass (CPB), and the relationship between PLD activity and systemic inflammatory response induced by CPB.

METHODSArterial blood was obtained from 26 patients undergoing open heart surgery at 8 different time points during the perioperative period, from which leukocytes were isolated for determination of PLD activity, CD11b expression and myeloperoxidase (MPO) activity. Plasma IL-6, IL-8 and C-reactive protein were also determined. The 26 cases were retrospectively divided into 3 groups according to perfusion time in order to detect the possible influences of CPB on PLD activity and IL-6 and IL-8 levels.

RESULTSWhen the ascending aorta was declamped, average arterial leukocyte PLD activity was 0.305 +/- 0.132 nmol choline.min(-1).mg(-1), 5.0 times higher of the pre-CPB value, and remained (5.4 times higher of the pre-CPB level) at 72 hours after CPB. Leukocyte CD11b expression and plasma IL-6 and IL-8 levels increased significantly at the end of CPB, while MPO activity and C-reactive protein concentration reached their peaks at 1 and 24 hours, respectively, after CPB. At the end of CPB, the arterial leukocyte PLD activity of patients whose CPB duration was longer than 90 minutes were 1.82- and 1.74-fold that of the other two groups with CPB lasting between 90 and 60 minutes and less than 60 minutes.

CONCLUSIONSArterial leukocyte PLD activity rises significantly in CPB and its elevation is earlier and more persistent than other inflammation-related indicators tested; longer CPB duration leads to higher leukocyte PLD activity at the end of CPB. These results imply that PLD could be a new target for prevention of systemic inflammatory response induced by CPB.

Adolescent ; Adult ; Cardiopulmonary Bypass ; Female ; Humans ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Leukocytes ; enzymology ; Male ; Middle Aged ; Phospholipase D ; blood ; Systemic Inflammatory Response Syndrome ; enzymology

This study was directed at estimating the value of platelet count in the course of in-vitro hemolytic tests by roller pump. Five paired in-vitro tests were conducted using the POLYSTAN pump(group A) and COBE pump(group B). The pumps ran 16 hours. The samples for platelet count and plasma-free hemoglobin were taken before pumping, and every 2 hours after 4 hours of pumping. The 2 groups' platelet count and plasma-free hemoglobin levels were found to be linearly increasing with the hours of pumping and linear regression analysis showed the platelet count and plasma-free hemoglobin were positively correlated. These data suggested that platelet count could be used as an index in evaluating the in-vitro hemolytic properties of blood pumps.
Assisted Circulation ; Hemoglobins ; analysis ; Hemolysis ; Humans ; Linear Models ; Platelet Count

To observe the erythrocyte fragility and morphological changes of erythrocytes caused by roller pump. Ten tests were divided into two groups, Polystan pediatric pump group A (n = 5) and COBE pump group B (n = 5). Ten whole blood samples (each 400 ml) were circulated in the roller pump for 16 h. Erythrocyte fragility and free hemoglobin were measured before pumping and at every 2 hours during pumping. The possible morphological changes of erythrocytes caused by roller pump were observed by scanning electron microscope. The electron microscopic observation was made before pumping and at every 4 hours throughout pumping. Results showed that the erythrocyte fragility of two groups was not increased during a long period of pumping. The number of acanthocytes of two groups was 1.77/1.81% in the samples before pumping and 6.12/7.13, 9.18/8.73, 13.21/12.89, 16.53/17.21% at 4 h, 8 h, 12 h, and 16 h respectively. The free hemoglobin level of two groups was increased linearly during a long duration of pumping and the index of hemolysis of two groups was 0.296 mg/L/h and 0.3993 mg/L/h respectively. The result shows: 1. the erythrocyte fragility was not increased during a long period of pumping; 2. the erythrocyte membrane was injured or broken by roller pump directly; 3. the morphological changes of erythrocytes would be the basis of post operative hemolysis.
Erythrocyte Deformability ; Heart-Lung Machine ; adverse effects ; Hemoglobins ; analysis ; Hemolysis ; Humans ; In Vitro Techniques ; Osmotic Fragility ; Time Factors

UNLABELLEDTo observe the antithrambotic property of a new prosthetic made double bileaflet valve of all-pyrolytic carbon.

METHODFifteen sheeps underwent mitral valve replacement (MVR) with this new mechanical valve. Each animal was placed on cardiopulmonary bypass. All of the sheep were given in an anticoagulation protocol and followed for three months. Final studies were performed on all animals surviving for more than 12 weeks.

RESULTTen sheeps died within 48 h after operation, five sheeps survived. The long-term survivors were killed forautopsies, two sheeps were killed in the 1st week after operation, one in 12th weeks and two in 2.5 years. Pathological examination of 10 sheeps which died early after operation revealed that there was no either evidence of thromboembotic phenomenon, or any failures of the mechanical valve. Autopsy studies in the five long-term survivors revealed that the sewing ring was covered by a thin layer of microthrombi consisted most of platelets and fibrin in 1th week after operation. The sewing rings was covered by a tissue layer, with partial organized micro thrombi and endothelialization in 12th weeks after the operation. Two and half years after operation, the complete endothelialization presented around the sewing ring without restriction of bileaflet motion. The tissue ingrowth tends to stop at the pyrolytic carbon-fabric interface on both surfaces of left atrium and ventricle. This study demonstrated that the new prosthetic heart valve had not promoted thrombosis and thrombembolism.

Animals ; Biocompatible Materials ; Carbon ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Male ; Materials Testing ; Sheep ; Thrombosis ; prevention & control

AIM: To evaluate the reliability of making a research model of coronary artery stenosis and local myocardial infarction reproduced in dog by ligating canine LAD. METHODS: We disparted 30 aged healthy cross-breed dogs [(18.5?6.7) kg] into three groups. The near part of the LAD through left minimal thoracic incision was ligated to interdict 25% (group A), 50% (group B), 75% (group C) of the flux, respectively. The changes of plasma endothelium-derived factors NO, ET-1, sP-selectin and CTnT were measured before ligation and at different time points after ligation. The expression of P-selectin gene in cardiac muscle was detected by Western blotting. The segments of distal parts of the ligated LAD were cut and pathological changes of the patches of topical cardiac muscle were observed by electronic microscope. RESULTS: After ligation, NO/ET-1, P-selectin and CTnT had significant changes in group B (P

AIM: To compare the effects of histidine-tryptophan-ketoglurate(HTK)solution, University of Wisconsin(UW)solution and St.Thomas(ST) Cardioplegia solution Ⅱ on hypothermic preservation of isolated rat hearts. METHODS: Isolated hearts from male Wistar rats were mounted on a Longendorff apparatus to estimate left ventricular end-diastolic pressure(LVEDP),left ventricular developed pressure(LVDP), rate of change of left ventricular pressure(d p /d t max ,d p /d t min ) and coronary flow(CF).Twenty-four rats were randomly divided into three groups: HTK group, UW groups and ST group.They were arrest and stored at 4℃ in each preservation solution for 6 hours. Following storage, they were reperfused and postpreservative function was measured to assess cardiac functional recovery. Frozen samples were analyzed for concentration of adenosine triphosphate. RESULTS: The concentration of adenosine triphosphate in three groups was significantly different( P

AIM: To study apoptosis in heart of multiple organ dysfunction syndrome (MODS) rat at high altitude. METHODS: The two-hit model of MODS rat was used at two different altitude(1 510 m, 3 900 m). Hemorrhage was induced in Wistar rats by catheterizing the femoral artery until a mean arterial pressure was 35 mmHg and maintained for 1 hour. Rususcitation was performed with lactated Ringer′s solution at 24 h after hemorrhage, cecal ligation and puncture(CLP) was performed .Then rats were killed at 3 h,6 h,12 h and 24 h after CLP, and myocardium sample was excised and stored in liquid nitrogen. Apoptosis in heart was determined by DNA agarose gel electrophoresis, flow cytometry(FCM), transmission electron microscope(TEM) and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL). RESULTS: The special ladder pattern for apoptosis was seen in myocardium sample at high altitude(3 900 m) group.The apoptotic rate in myocardium was higher in high altitude(3 900 m) group than that in lower altitude(1 510 m) group( P

AIM: We tested the hypothesis that marrow s tr omal cells (MSCs), when implanted into self-myocardium, can undergo milieu-depen dent differentiation, express cardiomyogenic phenotypes and enhance angiogenesis and cardiac function of ischemic hearts in vivo. METHODS: In order to achieve a safe and persistent effect, we ex plored the potential of autologous MSCs transplantation. One week after myo cardial infarction induced by occlusion of left anterior descending artery, auto logous MSCs labeled with BrdU (bromodeoxyuridine) in vitro was administered intramyocardially into the infarct area of the same donor rabbits. RESULTS: By 1 months, transplanted MSCs demonstrated to be myoge nic differentiation with the expression of ?-sarcomeric actin (5C5). MSCs impla ntation significantly increased vascular density in the infarct zone and resulte d in markedly improved the left ventricular contractility. CONCLUSION: The finding indicates that autologous MSCs transplan tation may represent a promising therapeutic strategy with free of ethical conce rns and immune rejection.

The effect of myocardium subjected to 60 min ischemia and 60 min reperfusion on the level of lipid peroxides (LPO) and function of myocardial mitochondria and activity of superoxide dismutase (SOD) was studied in cat cardiopulmonary bypass. Myocardial mitochondrial function was slightly depressed after 60 min ischemia but significantly depressed after 60 min reperfusion. Increased lipid peroxides content and decreased SOD activity were observed at 60 min ischemia. After reperfusion, the SOD activity continued decreasing, but LPO elevated apparently. These results support a hypothesis that the free radicals may contribute to the myocardial mitochondrial reperfusion injury.