| Autor: |
Axelrod, Howard I., Galloway, Aubrey C., Murphy, Michael S., Laschinger, John C., Gregory Baumann, F., Grossi, Eugene A., Glassman, Ephraim, Spencer, Frank C. |
| Zdroj: |
Journal of Thoracic and Cardiovascular Surgery; March 1987, Vol. 93 Issue: 3 p358-365, 8p |
| Abstrakt: |
Percutaneous total cardiopulmonary bypass offers the advantage of rapid, simple implementation without the need for thoracic incision and provides the ability to support both left and right ventricular failure as well as pulmonary insufficiency. Previous studies using roller pump percutaneous bypass were only partially successful because of the inability to effectively unload the left ventricle. In the present experiment we attempted to determine in a normal canine model whether use of synchronous pulsatile pumping for percutaneous bypass could overcome this problem. Fourteen dogs were placed on percutaneous bypass for 1 hour. A roller pump was used in seven and a synchronous pulsatile pump with an electrocardiogram triggering mechanism in the other seven. All animals were maintained on percutaneous bypass for 1 hour. In the pulsatile pump group there was a significantly greater percent decrease from baseline in tension-time index (–56.3% versus –19.1%, p<0.01) and in myocardial oxygen consumption (–45.8% versus +2.1 %, p < 0.05) and a significantly greater percent increase in the endocardial/epicardial blood flow ratio (27.6% versus –6.5%, p < 0.01) than in the roller pump group. These results show that superior unloading can be achieved by percutaneous pulsatile bypass compared with percutaneous roller pump bypass. The findings suggest that percutaneous total cardiopulmonary bypass with a synchronous pulsatile pump offers a relatively simple but effective method for providing appropriate patients with temporary hemodynamic stability before cardiac catheterization or medical or surgical revascularization. |
| Databáze: |
Supplemental Index |
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