Pig heart preservation with antegrade intracellular crystalloid versus antegrade/retrograde miniplegia

Both histidine-tryptophan-ketoglutarate (HTK) solution and Braile miniplegia are commercially available and used with high success. The objective of this work was to compare the effects of both strategies in an animal model. Twelve pigs were divided into control, HTK, or Braile groups using a model of controlled global cardiac ischemia/reperfusion under cardiopulmonary bypass with 1 hour heart ischemia followed by 2 hour reperfusion. No significant differences were found over time or between groups for heart rate, arrhythmia, number of defibrillations required, blood gases, myocardial lactate production, myocardial oxygen consumption, nor coronary flow index. The Braile strategy was associated with a lower 120 minute postreperfusion coronary vascular resistance with higher water content, leukocyte infiltration, and oxidative damage compared with controls. Drainage of HTK solution to the venous return was followed by higher potassium and lower sodium blood concentrations. One-hour heart preservation with HTK or Braile systems followed by 2 hour reperfusion both allow for acceptable preservation of the healthy pig myocardium. Maneuvers such as leukocyte filtration or hemofiltration may further improve these conditions.