How to improve flow during cardiopulmonary bypass in an acardia experimental model.

Details

Serval ID
serval:BIB_B52A39B9E94F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
How to improve flow during cardiopulmonary bypass in an acardia experimental model.
Journal
Interactive Cardiovascular and Thoracic Surgery
Author(s)
Marinakis S., Niclauss L., Rolf T., von Segesser L.K.
ISSN
1569-9285 (Electronic)
ISSN-L
1569-9285
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
15
Number
4
Pages
574-577
Language
english
Notes
Publication types: Journal Article
Abstract
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.
Pubmed
Web of science
Open Access
Yes
Create date
23/11/2012 22:40
Last modification date
20/08/2019 16:23
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