The Research Laboratory of the Department of Cardiovascular and Thoracic Surgery has ongoing projects that investigate myocardial metabolism under conditions that are encountered during cardiac surgical procedures. A focus of these investigations has centered on increasing our understanding of changes in myocardial substrate oxidation rates and substrate selection by the heart, particularly under conditions of cardioplegic arrest and hypothermia. Investigators in the laboratory have made novel observations that these conditions, which mimic those created in cardiac surgical operations, lead to a suppression of fatty acid utilization by the heart. Additional studies have probed the metabolic mechanisms behind this process using conventional biochemical analyses and magnetic resonance spectroscopy. These studies will increase our understanding of myocardial biochemistry and metabolism and may enable us to devise new methods to protect the heart during open-heart surgery.
Investigators in the laboratory have also used these techniques to study metabolism of the lung under conditions that simulate storage for lung transplantation. Here, early studies made the observation that a considerable degree of oxidative metabolism continues within pulmonary tissue during hypothermic storage and is related to the available alveolar oxygen in the stored pulmonary allografts. Lung metabolism can be influenced by altering the composition of the storage solution and these alterations can lead to improvements in post-reperfusion lung function. These studies may lead to the development of superior strategies for lung preservation for transplantation.
The laboratory is also leading a series of investigations that examine a new technique for preserving the heart for transplantation by providing a continuous flow of oxygen and nutrients to the heart over a prolonged storage interval. These studies are done in conjunction with an industry partner that is developing a perfusion preservation device. In addition to offering better long-term preservation, these studies may lead us to development of a way to obtain useable organs from marginal cardiac donors, thereby expanding the limited donor pool.
The laboratory is directed by Dr. Michael E. Jessen, M.D., professor and vice-chairman of the Department of Cardiovascular and Thoracic Surgery at UT Southwestern. Other investigators and collaborators include Dan M. Meyer, M.D. (Cardiovascular and Thoracic Surgery), Robert C. Eberhart, Ph. D. (Biomedical Engineering), Craig R. Malloy,M.D. (Rogers Magnetic Resonance Center), and A. Dean Sherry, Ph. D. (University of Dallas, Dept. of Chemistry). Research fellows in the laboratory have included trainees in General Surgery from UT Southwestern and from outside institutions in the U.S. and abroad and pre-doctoral and post-doctoral trainees in Biomedical Engineering. The laboratory has had continuous funding since 1991 from a variety of funding agencies including the National Institutes of Health, the American Heart Association, the American Lung Association, and the Texas Advanced Technology Program. Dr. Jessen was awarded the Lyndon Baines Johnson Research Award of the American Heart Association in 1994.
RESEARCH INTERESTS
Biocompatibility of materials for cardiopulmonary bypass and effects of the inflammatory response to extracorporeal circulation
Metabolic mechanisms of myocardial protection and the effects of substrate modifications on organ protective strategies
Dynamic organ preservation with continuous perfusion
RECENT PUBLICATIONS
Peltz M He TT, Adams GA, Chao RY, Jessen ME, Meyer DM, "Pyruvate-modified Perfadex improves lung function after long-term hypothermic storage" J Heart Lung Transplantation, 24:896-903, 2005
Peltz M, Douglass D, Meyer DM, Wait MA, DiMaio JM, Ring WS, Jessen ME, "Hypothermic circulatory arrest for repair of injuries of the thoracic aorta and great vessels" Interact Cardiovasc Thorac Surg, 5:560-565, 2006
Rosenbaum DH, Adams BC, Mitchell, JD, Jessen ME, Paul MC, Kaiser PA, Pappas PA, Meyer DM, WAit MA, Drazner MH, Yancy CW Jr, Ring WS, DiMaio,JM, "Effects of early steroid withdrawal after heart transplantation" Ann Thorac Surg, 82:637-644, 2006
Peltz M, He TT, Adams GA, Koshy S, Burgess SC, Chao RY, Meyer DM, Jessen ME, "Perfusion preservation maintains myocardial ATP levels and reduces apoptosis in an ex-vivo rat heart transplantation model" Surgery, 138:795-805, 2005
Rosenbaum, DH, Peltz, M, Merritt, ME, Thatcher, JE, Sasaki, H, Jessen, ME, "Benefits of perfusion preservation in canine hearts stored for short intervals." J Surg Research, 140:243-249, 2007
SIGNIFICANT PUBLICATIONS
Meyer DM, Jessen ME, "Extracorporeal Life Support" 2001
Jessen ME, Kovarik TE, Jeffrey FM, Sherry AD, Storey CJ, Chao RY, Ring WS, Malloy CR, "Effects of amino acids on substrate selection, anaplerosis and left ventricular function in the ischemic reperfused rat heart" J Clinical Invest, 92:831-839, Spring 1993
Meyer DM, Edwards LB, Torres F, Jessen ME, Novik RJ, "Impact of recipient age and procedure type on survival following lung transplantation for interstitial pulmonary fibrosis" Ann Thorac Surg, 79:950-0, 2005
Greilich PE, Brouse CF, Whitten CW, Chi L, DiMaio JM, Jessen ME, "Antifibrinolytic Therapy During Cardiopulmonary Bypass Reduces Proinflammatory cytokine levels: A randomized, double-blind placebo-controlled study of e-Aminocaproic acid and aprotinin" J Thorac Cardiovasc Surg, 126:1498-1503, 2003
Peltz M, He TT, Adams GA, Chao RY, Jessen ME, "Myocardial oxygen demand and redox state affect fatty acid oxidation in the potassium arrested heart" Surgery, 136:150-159, 2004
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