HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Axelrod, H. I. Articles by Spencer, F. C. Search for Related Content PubMed PubMed Citation Articles by Axelrod, H. I. Articles by Spencer, F. C.

The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 358-365, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Percutaneous cardiopulmonary bypass with a synchronous pulsatile pump combines effective unloading with ease of application

HI Axelrod, AC Galloway, MS Murphy, JC Laschinger, FG Baumann, EA Grossi, E Glassman and FC Spencer

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 less than 0.01) and in myocardial oxygen consumption (-45.8% versus +2.1%, p less than 0.05) and a significantly greater percent increase in the endocardial/epicardial blood flow ratio (27.6% versus -6.5%, p less than 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.

This article has been cited by other articles:

				G. W. Laub, S. Muralidharan, J. Reibman, J. Fernandez, W. A. Anderson, J. Gu, C. Daloisio, L. B. McGrath, and L. J. Mulligan ESMOLOL AND PERCUTANEOUS CARDIOPULMONARY BYPASS ENHANCE MYOCARDIAL SALVAGE DURING ISCHEMIA IN A DOG MODEL J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1085 - 1091. [Abstract] [Full Text]

				J. D. Fonger, Y. Zhou, H. Matsuura, G. S. Aldea, and R. J. Shemin Enhanced preservation of acutely ischemic myocardium with transseptal left ventricular assist Ann. Thorac. Surg., March 1, 1994; 57(3): 570 - 575. [Abstract] [PDF]

				H. Ide, A. Yamaguchi, T. Ino, H. Adachi, A. Mizuhara, K. Kawahito, H. Matsumoto, and I. Fujimasa Evaluation of the pulsatility of a new pulsatile left ventricular assist device--the integrated cardioassist catheter--in dogs J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 569 - 575. [Abstract] [Full Text]

				A. Moritz and E. Wolner Circulatory support with shock due to acute myocardial infarction Ann. Thorac. Surg., January 1, 1993; 55(1): 238 - 244. [Abstract] [PDF]

				S. Sukehiro and W. Flameng Effects of left ventricular assist for cardiogenic shock on cardiac function and organ blood flow distribution Ann. Thorac. Surg., September 1, 1990; 50(3): 374 - 383. [Abstract] [PDF]

				H. I. Axelrod, F. G. Baumann, and A. C. Galloway Left ventricular stress during extracorporeal membrane oxygenation Ann. Thorac. Surg., February 1, 1989; 47(2): 330 - 330. [PDF]

				J. E. Bavaria, M. B. Ratcliffe, K. B. Gupta, R. K. Wenger, D. K. Bogen, and L. H. Edmunds Jr. Changes in Left Ventricular Systolic Wall Stress during Biventricular Circulatory Assistance Ann. Thorac. Surg., May 1, 1988; 45(5): 526 - 532. [Abstract] [PDF]