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Cardiology Research and Practice
Volume 2013, Article ID 595838, 8 pages
http://dx.doi.org/10.1155/2013/595838
Research Article

Intracardiac Echocardiography Guided Transeptal Catheter Injection of Microspheres for Assessment of Cerebral Microcirculation in Experimental Models

1Intensive Care Department, Royal Brisbane and Women’s Hospital, Burns-Trauma & Critical Care Research Centre, The University of Queensland, Herston, QLD 4025, Australia
2Medical Engineering Research Facility, Queensland University of Technology, QLD, Australia
3Department of Cardiology, The Prince Charles Hospital, QLD, Australia
4Medical School Research Centre, Adelaide, SA, Australia
5Department of Anesthesiology, University of Texas Medical Branch, Galveston, USA
6Intensive Care Department, The Prince Charles Hospital and Medical Engineering Research Facility, Queensland University of Technology, QLD, Australia
7Department of Anaesthesiology and Intensive Care, Philipps University, Marburg, Germany
8Institute of Health and Biomedical Innovation & School of Public Health and Social Work, Queensland University of Technology, Australia

Received 27 April 2013; Revised 8 August 2013; Accepted 8 August 2013

Academic Editor: Gavin W. Lambert

Copyright © 2013 Judith Bellapart et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The use of microspheres for the determination of regional microvascular blood flow (RMBF) has previously used different approaches. This study presents for the first time the intracardiac injection of microspheres using transeptal puncture under intracardiac echocardiography guidance. Five Merino sheep were instrumented and cardiovascularly supported according to local guidelines. Two catheter sheaths into the internal jugular vein facilitated the introduction of an intracardiac probe and transeptal catheter, respectively. Five million colour coded microspheres were injected into the left atrium via this catheter. After euthanasia the brain was used as proof of principle and the endpoint for determination of microcirculation at different time points. Homogeneous allocation of microspheres to different regions of the brain was found over time. Alternate slices from both hemispheres showed the following flow ranges: for slice 02; 0.57–1.02 mL/min/g, slice 04; 0.45–1.42 mL/min/g, slice 06; 0.35–1.87 mL/min/g, slice 08; 0.46–1.77 mL/min/g, slice 10; 0.34–1.28 mL/min/g. A mixed effect regression model demonstrated that the confidence interval did include zero suggesting that the apparent variability intra- and intersubject was not statistically significant, supporting the stability and reproducibility of the injection technique. This study demonstrates the feasibility of the transeptal injection of microspheres, showing a homogeneous distribution of blood flow through the brain unchanged over time and has established a new interventional model for the measurement of RMBF in ovine models.