Left Ventricular or Biventricular Bypass With Local Heparinization

Taguchi, Kazumi; Murashita, J; Maruyama, Takashi; Nakagaki, Michihiko; Mochizuki, Takashi; Takamura, Keiichi; Matsumura, Makoto; Tsuchiya, Taro

doi:10.1097/00002480-197700230-00132

Cited by 8 publications

(7 citation statements)

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“…The evaluations included tests of the material, studies of the blood pumps, including valve design and driving systems, studies of the type of bypass, surgical considerations, hemodynamic analyses, and ease of weaning. In the overall, we failed to observe superiority of this system over the simple flow assist used in the second approach described above, which was previously shown [1] to have a very stable bypass course in all animals. The major difference between the 2 systems concerns whether flow is unloaded from the ventricle throughout the cardiac cycle, or whether the bypass flow is easily controllable at 30-40% of the cardiac output.…”

Section: Discussioncontrasting

confidence: 61%

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Results of acute and chronic experiments with assisted and total artificial heart

et al. 1980

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An assisted artificial heart and a total artificial heart were implanted in 108 calves. Two types of assisted artificial heart, a bladder type and a diaphragm type made of sflastic and segmented polyurethane, were tested in left atrial (LA) or left ventricular (LV) to abdominal aorta bypass. Of 40 calves that received LA bypass, 6 survived for more than 100 hours. Of 35 calves that received LV bypass, 18 survived for more than 100 hours. In the total artificial heart experiments, an oval-or sphere-shaped total artificial heart was implanted in 13 calves after 20 pilot experiments. That longest survival period was 864 hours (about 36 days), and the average survival time was 8.5 days.Encouraged with recent advances in development of an artificial heart reported elsewhere, we initiated a 5-year research program in 1974. During this period we developed a method for simple ventricular bypass support that was reliable for up to 7 weeks (1-3). Our present aim was permanent circulatory assistance or replacement with an implantable assisted or total heart. This paper presents a summary of our studies in a series of experiments involving 108 calves until August of 1977.

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Section: Discussioncontrasting

confidence: 61%

“…Acute circulatory assistance with simple dias- 2. Acute circulatory assistance with simple ventricular flow unloading for up to 7 weeks, if the balloon pumping fails to maintain life (left or biventricular bypass with local heparinization and blood fltration) [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

Results of acute and chronic experiments with assisted and total artificial heart

et al. 1980

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“…More recently Dem/is and co -work• ers and Z wart and co•workers have developed and applied techniques of prolonged left heart bypass in pali ents with cardiogenic shock after myoca rdial infarction with a can-nulation.technique allowing left heart bypass without thoracotomy (14,15,78). Litwak and co-workers, Taguchi and co-workers, Holub and co-workers, Pierce and co-workers, Senning and co-workers, and Bernhard and co-workers have used several methods of left heart bypass in patients who should not be weaned from cardiopulmonary bypass alter open heart surgery (3,26,38,56,72,73).…”

Section: Diicii Hiwlmentioning

confidence: 99%

Critical Analysis of Intra-aortic Balloon Counterpulsation and Transapical Left Ventricular Bypass in the Sufficient and Insufficient Circulation

Laas¹,

Cd²,

Takanashi³

et al. 1981

Thorac cardiovasc Surg

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Reduction of cardiac work/ oxygen consumption (LVQO2) may be beneficial in diminishing ischemic damage after myocardial infarction (MI). This study compares intra-aortic balloon pumping (IABP) and transapical left ventricular bypass (TALVB) to a specially developed method of LV assistance, i.e. transapical left ventricular bypass with complete LVdecompression (TALVB/ TD), a) in the sufficient circulation of swine for effectiveness in actively reducing myocardial oxygen requirements and b) in the insufficient circulation for effectiveness in improving circulatory dynamies, to reduce gross size and to prevent morphological damage in myocardial infarction in swine. Thirty-four pigs (17-29 kg) had standardized general anesthesia. a) In 10 of these animals LVQO2 was determined by measuring left coronary artery blood flow (LCBF) electromagnetically, blood samples for 02-content were taken from the aorta and the coronary vein draining the LV. Cardiac work/ oxygen consumption was related , during variable degrees of IABP assist and during total bypass , with graded reduction of LV pressure work , culminating in complete LV decompression (LV press. max. permanently below 8 mmHg). b) Twenty-four pigs underwent ligation of the LAD distal to the first diagonal branch and were divided into 4 groups. Six pigs served as controls. Starting 45 minutes after ligation 6 had 24-hour treatment with IABP, 6 had 24-hour TALVB and 6 animals were treated with TALVB/TD. Heart rate , central venous , pulmonary artery , aortic and left ventricular pressures and cardiac output were recorded prior to ligation and at 1/2, 1, 2 , 3, änd 24 hours. At 24 hours myocardial infarct size (MIS) was quantitated in g infaret per 100 g left ventricular and septal mass, and infarcted areas were examined histologically. a) In the sufficient circulation , heart rate , cardiac output, mean aortic , pulmonary artery , and central venous pressures were not significantly changed by IABP, TALVB, and TALVB/TD assist. During IABP (1:1), LVQO2 was decreased only 2.8%, LCBF was increased 4.4%, which is not significantly different from controls. Total LV bypass decreased LCBF 8.3% and LVQO2 18.1 %, total LV bypass with complete LV decompression reduced LCBF 31 % and LV(2O2 60.4% from control values. b) MI reduced mean aortic pressure (24.5%) and cardiac Output (47. 5%) significantly (p < .05). Confirmed in switchon/switch-off studies, IABP increased mean aortic pressure and cardiac output 4% to 9%. TALVB displaced 70% to 100% of the LV volume work, LV decompression was seen in 5 of the 6 TALVB animals (LVP syst. = AOP-11 mmHg). Transapical left ventricular bypass with a complete LV decompression immediately took over 100% LV volume work

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“…Twenty-six calves that underwent less than 21 days of left ventricular bypass were described in a previous report [1]. However, a brief description is warranted (Tabl e 2).…”

Section: Experiments In Calvesmentioning

confidence: 99%

“…handle the circulatory load. Our present approach involves temporary ventricular flow unloading utilizing transapical left ventricular bypass (TALVB) or, if necessary, biventricular bypass with local heparinization of the circuit [ 1,2] for up to 6 weeks. The novelty and rationale of this type of circulatory support have been reported previously [3][4][5].…”

mentioning

confidence: 99%

Transapical left ventricular bypass with local heparinization for prolonged circulatory support

et al. 1980

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An avcothanized vinyl sheet consisting of a Pall filter, 2 pressure monitoring lilnes, 2 heparinization lines, and a roller pump was used for transapical left ventricular bypass in 36 calves and 11 patients. Blood was returned to the abdominal or ascending aorta or carotid artery. Prolonged left ventricular flow unloading was carried out. All 31 calves that underwent left ventricular bypass and 5 calves that underwent left ventricular bypass and 5 calves that underwent biventricular bypass survived the scheduled period of bypass of up to 7 weeks except for 2 calves that died of accidental air embolism and 2 that were deliberately sacrificed due to infection. Local heparinization for 6 days followed by oral anticoagulation to maintain the prothrombin time at 150-200% of normal were effective in keeping the animals from bleeding and preventing thromboembolism. Eleven critically ill patients with severe heart disease were supported with left or biventricular bypass for periods of up to 172 hours. Four patients ultimately recovered, and 3 others were successfully weaned from bypass and expired 1-4 months later.

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Left Ventricular or Biventricular Bypass With Local Heparinization

Cited by 8 publications

References 0 publications

Results of acute and chronic experiments with assisted and total artificial heart

Results of acute and chronic experiments with assisted and total artificial heart

Critical Analysis of Intra-aortic Balloon Counterpulsation and Transapical Left Ventricular Bypass in the Sufficient and Insufficient Circulation

Transapical left ventricular bypass with local heparinization for prolonged circulatory support

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