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腹腔內 同種心臟移植에 關한 實驗的 硏究

Heterotopic Heart Transplantation in Canine Abdominal Cavity

최신의학 1969년 12권 11호 p.35 ~ 47
이진범,
소속 상세정보
이진범 (  ) - 서울대학교 의과대학 흉부외과학교실

Abstract


Heterotopic homograft of puppy heart into the abdominal cavity was carried out. The donor heart was cooled to about 4°C by immersingin cold saline. The abdomen of the recipient was opened by median incision.
The abdominal aorta and inferior vena cava were clamped and ends of the great vessel stumps were anastomosed to the lateral walls of the host vessels. Before operation EKG on both donor and recipient r were checked and after grafting postopeative EKG was repeated.
Intracardiac pressure and blood pressure of the great vessels were measured by twin-viso pre- and post-operatively.
By injecting contrast media into the host´s aorta proximal to the cardiac transplant anastomosis site directly, angiocardiography was done. Twenty canine hearts were transplanted, among which there were six ,operative deaths including two sacrificed dogs. Six dogs survived less than 6 hours, four dogs 6 to 24 hours, land four dogs more than 1 day. The longest survived 18 days without any immunosuppressive measures.
Immediately after releasing the vasculer clamps in seven dogs ventricular fibrillation was noted, which was converted into normal sinus rhythm with single defibrillator shock.
In nine dogs cardiac beats were so weak that cardiac massage of short duration was necessary. Only in r four dogs no additional manipulation was needed. In the most of the cases the transplanted heart showed some degree of acute dilatation.
By direct puncture pressure tracing with twin-viso, postoperative pressure increase in the right side of hart and decrease in the left side of heart were noted.
Viability of the transplanted heart was examined by abdominal palpation and EKG. In long term survivors definite postoparative EKG findings, which were noted up to 4 days, became unclear after this period. Angiocardiogram showed dilated cardiac shadow, in which the right side of heart was more prominently increased in size

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