%0 Journal Article
%T Intracoronary hypothermia for acute myocardial infarction in the isolated beating pig heart
%A Frans N van de Vosse
%A Lokien X van Nunen
%A Luuk C Otterspoor
%A Marcel CM Rutten
%A Marcel vanˇŻt Veer
%A Marco Stijnen
%A Nico HJ Pijls
%A Sjoerd Van Tuijl
%A TilaŁż T Rosalina
%J Archive of "American Journal of Translational Research".
%D 2017
%X Hypothermia may attenuate reperfusion injury and thereby improve acute myocardial infarction therapy. Systemic cooling trials failed to reduce infarct size, perhaps because the target temperature was not reached fast enough. The use of selective intracoronary hypothermia combined with intracoronary temperature monitoring allows for titrating to target temperature and optimizing the cooling rate. We aimed to the test the feasibility of intracoronary cooling for controlled, selective myocardial hypothermia in an isolated beating pig heart. In five porcine hearts the left anterior descending artery (LAD) was occluded by an over-the-wire balloon (OTWB). After occlusion, saline at 22ˇăC was infused through the OTWB lumen for 5 minutes into the infarct area at a rate of 30 ml/min. Thereafter the balloon was deflated but infusion continued with saline at 4ˇăC for 5 minutes. Distal coronary temperature was continuously monitored by a pressure/temperature guidewire. Myocardial temperature at several locations in the infarct and control areas was recorded using needle thermistors. In the occlusion phase, coronary temperature decreased by 11.4ˇăC (range 9.4-12.5ˇăC). Myocardial temperature throughout the infarct area decreased by 5.1ˇăC (range 1.8-8.1ˇăC) within three minutes. During the reperfusion phase, coronary temperature decreased by 6.2ˇăC (range 4.1-10.3ˇăC) and myocardial temperature decreased by 4.5ˇăC (range 1.5-7.4ˇăC). Myocardial temperature outside the infarct area was not affected. In the isolated beating pig heart with acute occlusion of the LAD, we were able to rapidly ˇ°induce, maintain, and controlˇ± a stable intracoronary and myocardial target temperature of at least 4ˇăC below body temperature without side effects and using standard PCI equipment, justifying further studies of this technique in humans
%K Intracoronary hypothermia
%K acute myocardial infarction
%K reperfusion injury
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340690/