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conferenceseries.com
Volume 8 Surgery: Current Research Open Access Surgery Asia Pacific 2018
August 17-18, 2018
August 17-18, 2018 Singapore
12th International Conference on
Surgery and Anesthesia
Tomasz Kameczura et al., Surgery Curr Res 2018, Volume 8
DOI: 10.4172/2161-1076-C3-041
The use of direct heart hypothermia by MET cooler reduces left ventricular systolic function
impairment in animal experimental model of myocardial infarction: Ongoing study
Tomasz Kameczura1, Sebastian Stec1, Marek Rajzer2, Jerzy Wilinski3, Stanisław Bartus2 and Alex Pasek5
1University of Rzeszow, Poland
2Jagiellonian University, Poland
3Blessed Marta Wiecka District Hospital, Poland
Background: The reduction of heart damage and improvement of patient outcome are the main goals in the treatment of
myocardial infarction. For both crucial are the shortening of time to reperfusion and use of appropriate pharmacological
treatment. Two commonly recognizedmilestones in this area are the techniques of mechanical reperfusion and new generations
of antiplatelet drugs. Restrain of myocardial metabolic activity seems to be possible third way, which may have an impact on
myocardial damage especially during the critical ischemia. The use of direct heart hypothermia to reduce myocardial metabolic
activity is very promising tool for reducing left ventricle damage and improve patient’s prognosis.
Method: The study is conducted using an animal model. We compare 20 domestic swine (Polish Landrace Pig), 10 in the
Study Group (SG) and 10 in the Control Group (CG). The animals in both groups were randomly paired by age, sex and
body mass. Animals in the CG are sequentially given analgesia, sedation and respiratory therapy. After that we get an arterial
access (femoral artery), perform coronary-angiography and by using Balloon Catheter (BC) perform inflation in proximal
part of LAD (POBA) (target prox/mid LAD with a diameter of 2.5-4.0 mm behind ostium DG1). After 45 minutes the BC
is removed from the LAD. The animal is observed, monitored (if necessary appropriate medication is given). Past 48-hours
since POBA the EF assessment (Ejection Fraction) of LV is performed. Then the subject is euthanized and staining of heart
tissue is performed with quantitative assessment of Infarct Area (IA) and Area at Risk (AAR). Similarly, in SG the coronary
angiography is performed with POBA LAD. After removal of BC from the LAD, a dry puncture of pericardium (pericardial
catheter inserted to the pericardial sac) is performed, with subsequent 12 hours procedure of direct hypothermia of heart
(saline 30 °C). 48 hours since POBA, there the evaluation of EF is made, subject is euthanized, then same staining procedures
as in control group performed with quantitative assessment OD AI and AAR.
Result: Comparison of baseline EF and MVO in CG1 and SG1 showed no significant differences (all p>0.05). MVO was
significantly reduced at SG2 and EF was significantly greater in SG2 comparison to the CG2. Similarly, for the EF and MVO
significant difference was observed between the SG2 and CG2 (p<0.001).
Conclusion: Direct Heart Hypothermia (DHH) method by METcooler in acute experimental heart ischemia is a viable and
safe method in an animal model. Dry pericardial puncture and lowering the temperature in the pericardial sac by applying a
closed refrigerant circuit are relatively simple procedures that can be performed if necessary in a regular cath-lab/cardiology
department. Preliminary results demonstrate that the DHHmay be considered in the future as an additional method to reduce
cardiac damage in the course of myocardial infarction.
Biography
Tomasz Kameczura is Interventional cardiologist experienced in invasive cardiology, currently dealing with ACS's and elective PCI's and is the founder of
NewTechMed LLC/NY/USA.