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Related Experiment Videos

Concepts in assisted circulation.

A A Lefemine1, J Dunbar, A Delucia

  • 1Department of Surgery, V.A. Medical Center and Quillen-Dishner College of Medicine, Johnson City, Tennessee 37601, USA.

Texas Heart Institute Journal
|March 1, 1986
PubMed
Summary
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Assisted circulation using left ventricular and right atrial bypass without oxygenation achieved 100% survival in dogs with severe heart failure. This technique effectively supports circulation and decompresses both ventricles, offering a promising method for cardiac assistance.

Area of Science:

  • Cardiovascular Surgery
  • Mechanical Circulatory Support
  • Critical Care Medicine

Background:

  • Cardiogenic shock often presents as a biventricular problem requiring biventricular decompression.
  • Existing extracorporeal bypass techniques have complexities, particularly concerning long-term pulmonary oxygenation.
  • Assisted circulation principles can be applied via temporary extra-thoracic or long-term intracorporeal devices.

Purpose of the Study:

  • To compare the efficacy of various extracorporeal mechanical bypass techniques in supporting circulation during severe biventricular failure.
  • To evaluate the survival rates and hemodynamic improvements offered by different bypass configurations.
  • To determine the feasibility of a low-flow bypass without an oxygenator for cardiac assistance.

Main Methods:

Related Experiment Videos

  • Comparison of left ventricular bypass, left atrial bypass, and combined left ventricular plus right atrial bypass in a canine model of myocardial infarction.
  • Inclusion of control groups receiving nitroprusside, metabolic substrates, or no therapy.
  • Assessment of survival rates, respiration, acid-base balance, hemodynamics, lactic acid, CPK, and oxygen consumption over 4-hour treatment periods.

Main Results:

  • Left ventricular plus right atrial bypass achieved 100% survival during the 4-hour treatment period, significantly outperforming other methods.
  • Right atrial bypass alone provided adequate right ventricular decompression without adversely affecting respiration or acid-base balance.
  • Combined bypass improved hemodynamics, total body perfusion, and ventricular function even at reduced flow rates, with similar benefits observed in metabolic markers.

Conclusions:

  • A low-flow left ventricular plus right atrial bypass technique, excluding an oxygenator, is highly effective for short- or long-term cardiac assistance.
  • This method successfully decompresses both ventricles and maintains adequate circulation and cardiac rhythm in severe biventricular failure.
  • Metabolic substrates did not enhance survival but may act as modulators; further research is warranted.