How to improve flow during cardiopulmonary bypass in an acardia experimental model
| Autor: | Ludwig K. von Segesser, Sotirios Marinakis, Tanina Rolf, Lars Niclauss |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Pulmonary and Respiratory Medicine
Pulmonary Circulation medicine.medical_specialty medicine.medical_treatment Hemodynamics Pulmonary Artery New Ideas law.invention Extracorporeal Membrane Oxygenation law Internal medicine medicine.artery medicine Cardiopulmonary bypass Extracorporeal membrane oxygenation Animals Cardiac Surgical Procedures Heart transplantation Cardiopulmonary Bypass business.industry medicine.disease Constriction Cannula Disease Models Animal Pulmonary Veins Great arteries Anesthesia Ventricular Fibrillation Ventricular fibrillation Pulmonary artery Cardiology Feasibility Studies Cattle Surgery Cardiology and Cardiovascular Medicine business Blood Flow Velocity |
| Zdroj: | Interactive CardioVascular and Thoracic Surgery. 15:574-577 |
| ISSN: | 1569-9285 1569-9293 |
| DOI: | 10.1093/icvts/ivs242 |
| Popis: | OBJECTIVES In extreme scenarios, such as hyperacute rejection of heart transplant, an urgent heart explantation might be necessary. The aim of this experimental study was to determine the feasibility and to improve the haemodynamics of a venoarterial cardiopulmonary bypass after cardiectomy. METHODS A venoarterial cardiopulmonary bypass was established in seven calves (56.4 ± 7 kg) by the transjugular insertion to the caval axis of a self-expanding cannula, with a carotid artery return. After baseline measurements (A), ventricular fibrillation was induced (B), great arteries were clamped (C), the heart was excised and the right and left atria remnants, containing the pulmonary veins, were sutured together leaving an atrial septal defect over the cannula in the caval axis (D). Measurements were taken with the pulmonary artery clamped and declamped. RESULTS Initial pump flow was 4.16 ± 0.75 l/min dropping to 2.9 ± 0.63 l/min (P(AB )< 0.001) 10 min after induction of ventricular fibrillation. After cardiectomy with the pulmonary artery clamped, the pump flow increased non-significantly to 3.20 ± 0.78 l/min. After declamping, the flow significantly increased close to baseline levels (3.61 ± 0.73 l/min, P(DB )= 0.009, P(DC )= 0.017), supporting the notion that full cardiopulmonary bypass in acardia is feasible only if adequate drainage of pulmonary circulation is assured to avoid pulmonary congestion and loss of volume from the left-to-right shunt of bronchial vessels. |
| Databáze: | OpenAIRE |
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