Leukocyte depletion in a neonatal model of cardiac surgery

Ian C. Wilson, Joseph M. DiNatale, A. Marc Gillinov, William E. Curtis, Duke E. Cameron, Timothy J. Gardner

Research output: Contribution to journalArticle

Abstract

Neonatal cardiac surgical procedures continue to be associated with a considerable incidence of severe post-operative ventricular dysfunction. The role of neutrophils in mediating such injury has recently been proposed but remains controversial. The present study was undertaken to examine the potential benefits of leukocyte depletion for myocardial preservation using an in situ, in vivo porcine model of neonatal cardiac surgery. Sixteen 3- to 5-day-old piglets, 8 controls and 8 leukocyte-depleted animals (LD group), underwent 90 minutes of hypothermic ischemia. Mechanical leukocyte filtration during cardiopulmonary bypass reduced the granulocyte count in the initial reperfusate to 0.7% of controls. This was associated with a reduction in leukocyte sequestration in the coronary vascular bed (p < 0.005), a decrease in myocardial creatine kinase release (p < 0.02), and a reduction in coronary vascular resistance (p < 0.03). These changes in physiological response to ischemia were associated with improved postischemic recovery of left ventricular systolic function in LD animals (p < 0.05), although there was no significant improvement in diastolic function. Application of this technique in neonatal cardiac operations may improve myocardial protection and reduce the associated morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)12-19
Number of pages8
JournalThe Annals of thoracic surgery
Volume55
Issue number1
DOIs
StatePublished - Jan 1993

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ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Wilson, I. C., DiNatale, J. M., Gillinov, A. M., Curtis, W. E., Cameron, D. E., & Gardner, T. J. (1993). Leukocyte depletion in a neonatal model of cardiac surgery. The Annals of thoracic surgery, 55(1), 12-19. https://doi.org/10.1016/0003-4975(93)90467-V