Detecting myocardial ischaemia with optochemical sensing by using a fluorescent hydrogel

Abstract

Myocardial ischaemia induced by cardioplegia is the most prominent risk during open-heart surgery. To achieve adequate protection of the cardiomyocytes during surgery, the cardioplegia must arrive at all cardiomyocytes. Local obstruction can lead to regional ischaemia. For surgeons and perfusionist, the arrested heart is a black box. They know how much cardioplegia they are administering to the heart. However, they do not know if cardioplegia is reaching all cells. This work describes which parameters can be measured during cardioplegia induced cardiac arrest and compares the methods used in the literature to detect these parameters. Following this, it is the goal to create a proof-­of-­concept sensor for the detection of myocardial ischaemia. A literature review indicated that a fluorescent optochemical pH sensor has the most potential. To be able to develop a proof-­of-­concept, optical, chemical, and medical knowledge needs to be combined. This is necessary to map what is required and what is possible for optochemical in vivo sensing. First, a framework is designed and used to select the best technique and material suited for this project. In this framework, the medical requirements and the resources available are combined. As a result, this thesis work will use a dual wavelength pH­-sensitive fluorescent dye encapsulated in a biocompatible hydrogel. In preparation for the proof-­of-­conceptsensor, multiple samples are fabricated and extensively tested to achieve the optimal sensing layer. Using the optimised concentrations, a proof-­of-­conceptsensor is created using a miniature reflection probe and an USB spectrometer. This proof-­of-­conceptsensor shows that it can measure the changes in pH and can be corrected for multiple interferences. It also shows the potential to be further miniaturised and to be used during cardiac surgery. Before this can happen, chemical optimisation of the sensing layer is needed, and the consistency of the sensing layer needs to be improved. However, besides this, the work succeeded in selecting an optochemical sensing technique and material which shows the potential to be used in cardiac surgery