Extracorporeal membrane oxygenation (ECMO) is a well-established therapy for the temporary substitution for the heart and/or lungs in patients with acute cardiac or pulmonary failure. Recently, the development of portable systems has allowed for implementation of therapy outside of the intensive care units. ECMO can even be initiated in out-of-hospital situations to allow for patient stabilization and subsequent transfer to an appropriate hospital. This chapter will focus on the authors' development of a perfusion system based on a new double chamber pump. This unique design will, in theory, allow for a more complete and effective circulatory support to allow for myocardial and pulmonary recovery. The evolution from bench-top to animal testing will be described. The theoretical issues-including the advantages and disadvantages of roller and centrifugal pump designs-will also be discussed.

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Using a new heart-lung machine developed at our Institute, experiments were conducted on dogs, donkeys, and monkeys, providing complete and assisted artificial circulation, assisted oxygenation, and perfusion preservation of the heart. The new apparatus consists of two sequentially mounted artificial ventricles working in an antiphase mode; blood oxygenation is accomplished by a reusable oxygenator with a fluorocarbon preoxygenator. Experimental results indicate that clinical use of the apparatus is promising and deserves consideration. The conditions of perfusion were close to physiological conditions and provided long-term survival of the animals. Performance in left ventricular bypass was optimized by monitoring myocardial PO2 and the state of the quick-connect/cut-off assemblies.