Mechanical Tissue Resuscitation (MTR) Reduces Myocardial Reperfusion Injury

Abstract

Treating injured tissue with negative pressure re‐establishes physiologic homeostasis and improves tissue survival. Injury sustained following reperfusion of ischemic myocardium involves processes similar to those seen after burns and other wounds. This study explores the possibility of using a mechanical device to achieve local resuscitation of myocardial tissue following acute myocardial infarction.Anesthetized swine were subjected to 75 min of left coronary artery occlusion and 3 hours of reperfusion. Animals were assigned to 1 of 3 groups: (1) control, treatment with (2) 50 mmHg or (3) 125 mmHg of MTR during reperfusion. All three groups were subjected to equivalent ischemic stress [area of risk (AAR) =12.9± 1.2%, 11.8±1.2% and 11.9±1.4%, respectively]. The application of MTR directly to the injured myocardium for 180 minutes significantly (p<0.001) reduced infarct size in both treatment groups compared to control: 9.3±1.8% (50 mm Hg) vs 26.4±2.1% (control); and 11.9±1.2% (125 mm Hg) vs 26.4±2.1% (control).Application of a controlled vacuum device directly to the injured myocardium for a defined period of time can achieve MTR and reduce tissue death after ischemia and reperfusion. This treatment strategy offers a simple, effective, clinically relevant, non‐pharmacologic approach to reducing myocardial injury following ischemia and reperfusion.