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Long-term preservation of a beating heart in an artificial environment.

The natural heart could be preserved in the beating state, with appropriate afterload, for more than 24 hrs if supported by blood compatible artificial organs and biomedical engineering techniques. An artificial environment was developed using this philosophy. The system was constructed from four subsystems: circulatory, respiratory, metabolic, and environmental. In the circulatory subsystem, diastolic pressure was held at 70 to 100 mmHg by computer aided peripheral resistance, and a left ventricular assist device (LVAD) could be added when cardiac function was weakened. The respiratory subsystem was composed of an artificial lung and computer aided gas mixer for O2, CO2, and air, which kept blood PO2 and PCO2 within physiologic levels. In the metabolic subsystem, glucose and insulin were injected by infusion pump so as to maintain blood sugar within 100 to 200 mg/dl, whereas the environmental system preserved the isolated heart at 37 degrees C in a sterile water bath. Goats' hearts were connected to this system, and continued to beat for a maximum of 24 hours.