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Intermittent Antegrade Cardioplegia: Isolated Heart Preservation with the Asporto Heart Preservation Device

follows standard techniques that were optimized by Lower and Shumway.1 Through animal and clinical studies, they determined that hypothermia and a short (3-4 hours) preservation time were the optimal means for maintaining viability of donor hearts under hypoxic conditions. In order to minimize tissue breakdown, the heart is then transported to the recipient as quickly as possible. Under such hypothermic and hypoxic conditions, myocardial cells maintain some basal level of metabolic activity that leads to intracellular acidosis and metabolite formation.2 Although it is difficult to assess the degree of myocardial degradation with a method that is feasible for the clinical setting, we recently developed a technique to examine microvasculature of donor hearts by using cardiac perfusion magnetic resonance (MR) imaging. Initial experiences with donor heart imaging included the observations of air embolism identified by gross pathology and confirmed by perfusion MR imaging.3 Since then, we have successfully addressed the problem of air bubbles and embolus formation by using a rigorous cardiac deairing protocol. This procedure Intermittent antegrade cardioplegia: isolated heart preservation with the Asporto heart preservation device