Skip to main content
SpringerLink
Log in

Effects of pulsatile and non-pulsatile perfusion on the isolated canine heart

  • Original Contributions
  • Published:
Research in Experimental Medicine

Summary

Isolated canine hearts with a critical stenosis on one coronary artery were perfused for 2 h with blood from supporting dogs using a new roller pump system that can deliver pulsatile or non-pulsatile flow perfusion. Non-pulsatile perfusion caused a decrease in coronary venous oxygen tension of 22% (P < 0.05) accompanied by increasing carbon dioxide tension of 50% (P < 0.02). With pulsatile flow coronary venous oxygen and carbon dioxide tensions remained stable. Non-pulsatile perfusion decreased the coronary arteriovenous oxygen difference by 35% (P < 0.02), coronary blood flow by 40% (P < 0.02), and myocardial oxygen consumption by 54% (P < 0.01) whereas pulsatile flow did not change any of these variables. Subendocardial blood flow distal to the stenosis fell by 0.15±0.04 ml/min per gram myocardium (mean±S.E.M.) (P < 0.01) during linear perfusion. The endocardial/epicardial-flow ratio was less than one and decreased further during fibrillation period indicating underperfusion of the endocardial muscle region. With pulsatile flow subendocardial flow remained unaltered during the two hours of fibrillation. Edema formation was 24% in hearts subjected to non-pulsatile flow but only 14% in hearts perfused by pulsatile perfusion (P < 0.05). Accordingly, the ischemic area involved 40% of the left ventricle during non-pulsatile flow but 25% of the left ventricle in hearts perfused by pulsatile perfusion (P < 0.05).

The results indicate that pulsatile flow perfusion may prevent severe hemodynamic, hematologic, and metabolic alterations in fibrillating isolated canine hearts. It is suggested that pulsatile perfusion may be useful for fibrillating hearts during open heart surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Baird RJ, Dutka F, Okumori M, de la Rocha A, Goldbach MM, Hill TJ, MacGregor DC (1975) Surgical aspects of regional myocardial blood flow and myocardial pressure. J Thorac Cardiovasc Surg 69:17–29

    PubMed  Google Scholar 

  2. Bregman D (1977) Hemodynamic effects of pulsatile blood flow. In: Balooki H (ed) Clinical application of intra-aortic balloon pumps, vol 1. Futura, New York, pp 29–39

    Google Scholar 

  3. Ciardullo R, Schaff HV, Flaherty JT, Gott VL (1977) Myocardial ischemia during cardiopulmonary bypass. J Thorac Cardiovasc Surg 69:746–757

    Google Scholar 

  4. Cross CE (1964) Influence of coronary arterial pressure on coronary vasomotor tonus. Symposium autoregulation of blood flow. Circ Res 14/15 [Suppl I]:187–192

    Google Scholar 

  5. Dalton ML, McCarty RT, Woodward KE, Bavila TG (1965) The army artificial heart pump, vol II. Comparison of pulsatile and non-pulsatile flow. Surgery 58:840–845

    PubMed  Google Scholar 

  6. Dunn J, Kirsh MM, Harness J, Carroll M, Straker J, Sloan H (1974) Hemodynamic, metabolic, and hematologic effects of pulsatile cardiopulmonary bypass. J Thorac Cardiovasc Surg 68:138–147

    PubMed  Google Scholar 

  7. Dunnett CW (1964) New tables for multiple comparisons with a control. Biometrics 20:482–491

    Google Scholar 

  8. Elsinga WE, Skinner DB (1975) Hemodynamic characteristics of critical stenosis in canine coronary arteries. J Thorac Cardiovasc Surg 69:217–222

    PubMed  Google Scholar 

  9. Galletti PM, Brecher GA (1962) Theory of blood pumps. In: Galletti PW, Brecher GA (eds) Heart-lung bypass. Principles and techniques of extracorporeal circuit. Grune & Stratton, Chapter 8, New York, pp 121–124

    Google Scholar 

  10. Habal SM, Weiss MD, Spotnitz HM, Parodi EN, Wolff M, Cannon PJ, Hoffman BF, Malm JR (1976) Effects of pulsatile and non-pulsatile coronary perfusion on performance of the canine left ventricle. J Thorac Cardiovasc Surg 72:742–753

    PubMed  Google Scholar 

  11. Heymann MA, Payne BD, Hoffmann JIE, Rudolph AM (1977) Blood flow measurements with radionuclide-labeled particles. Progs Cardiovasc Dis 20:55–79

    Google Scholar 

  12. Hottenrott CE, Maloney JV, Buckberg GD (1974) Studies on the effect of ventricular fibrillation on the adequacy of regional myocardial flow, vol III. Mechanisms of ischemia. J Thorac Cardiovasc Surg 68:634–645

    PubMed  Google Scholar 

  13. Huisman PH, Schipperheyn JJ (1978) The isolated heart-lung preparation. Martinus Nijhoff Medical Division, The Hague, p 36

    Google Scholar 

  14. Kettler D, Cott L, Hensel M, Martel J, Bretschneider HJ (1970) Combination of dipiritramide and N2O, a new anaesthetic method for studies of cardiovascular function in dogs. Pflügers Arch 319:42–43

    Google Scholar 

  15. Kusumi F, Butts WC, Ruff WL (1973) Superior analytic performance by electrolytic cell analysis of blood oxygen content. J Appl Physiol 35:299–300

    PubMed  Google Scholar 

  16. Mavroudis C (1978) To pulse and not to pulse. Ann Thorac Surg 25:259–271

    PubMed  Google Scholar 

  17. Monroe RG, Gamble MJ, LaFarge CG, Benouvalid H, Weisul J (1975) Transmural coronary venous O2 saturation in normal and isolated hearts. Am J Physiol 228:318–324

    PubMed  Google Scholar 

  18. Mukherjee ND, Beran AV, Hirai J, Wakabayashi A, Sperling DR, Taylor WF, Connolly JE (1973) In vivo determination of renal tissue oxygenation during pulsatile and nonpulsatile left heart bypass. Ann Thorac Surg 15:354–363

    PubMed  Google Scholar 

  19. Nachlas MM, Shnitka TK (1963) Macroscopic identification of early myocardial infarcts by alterations in dehydrogenase activity. Am J Pathol 42:379–405

    PubMed  Google Scholar 

  20. Ogata T, Ida Y, Nonoyama A, Takeda J, Sasaki H (1960) A comparative study on the effectiveness of pulsatile and non-pulsatile blood flow in extracorporeal circulation. Arch Jpn Chir 29:59–66

    Google Scholar 

  21. Opie LH (1980) Myocardial infarct size, part I. Basic considerations. Am Heart J 100:355–372

    PubMed  Google Scholar 

  22. Reimer KA, Jennings RB (1979) The “waveform phenomenon” of myocardial cell death. II. Transmural progression of necrosis within the framework of ischemic bed size (myocardium at risk) and collateral flow. Lab Invest 40:633–644

    PubMed  Google Scholar 

  23. Roberts AJ, Niarchos AP, Subramanian VA, Abel RM, Herman SD, Sealey JE, Case DB, White RP, Johnson GA, Laragh JH, Gay WA (1977) Systemic hypertension associated with coronary artery bypass surgery. J Thorac Cardiovasc Surg 74:846–859

    PubMed  Google Scholar 

  24. Rubio R, Berne RM (1975) Regulation of coronary blood flow. Pro Cardiovasc Dis 18:105–122

    Google Scholar 

  25. Schaff HV, Ciardullo RC, Flaherty JT, Brawley RK, Gott VL (1977) Regional ischemia distal to a critical coronary stenosis during prolonged fibrillation — Improvement with pulsatile perfusion. Circulation 56 [Suppl II]:1125–1132

    Google Scholar 

  26. Schaper W, Frenzel H, Hort W (1979) Experimental coronary artery occlusion, vol I. Measurement of infarct size. Basic Res Cardiol 74:46–53

    PubMed  Google Scholar 

  27. Shepard RB, Kirklin JW (1969) Relation of pulsatile flow to oxygen consumption and other variables during cardiopulmonary bypass. J Thorac Cardiovasc Surg 58:694–702

    PubMed  Google Scholar 

  28. Spencer FC (1974) Acquired heart disease. In: Schwartz SI, Lillehei RC, Shires GT, Spencer FC, Stover EH (eds) Principles of surgery, 2nd ed. McGraw-Hill Book, New York, pp 753–759

    Google Scholar 

  29. Stinson EB, Holloway EL, Derby GC, Copeland JG, Oyer PE, Beuhler DL, Griepp RB (1977) Control of myocardial performance early after open-heart operations by vasodilator treatment. J Thorac Cardiovasc Surg 73:523–530

    PubMed  Google Scholar 

  30. Taylor KM, Bain WH, Maxted KJ, Hutton MM, McNab WY, Caves PK (1978) Comparative studies of pulsatile and nonpulsatile flow during cardiopulmonary bypass, vol I. Pulsatile system employed and its hematologic effects. J Thorac Cardiovasc Surg 75:569–573

    PubMed  Google Scholar 

  31. Taylor KM, Wright GS, Reid JM, Bain WH, Caves PK, Walker MS, Grant JK (1978) Comparative studies of pulsatile and non-pulsatile flow during cardiopulmonary bypass, vol II. The effects on adrenal secretion of cortisol. J Thorac Cardiovasc Surg 75:574–578

    PubMed  Google Scholar 

  32. Taylor KM, Wright GS, Bain WH, Caves PK, Beastell GS (1978) Comparative studies of pulsatile and nonpulsatile flow during cardiopulmonary bypass, vol III. Response of anterior pituitary gland to thyrotropin-realising hormone. J Thorac Cardiovasc Surg 75:579–584

    PubMed  Google Scholar 

  33. Taylor KM, Bain WH, Russel M, Brannan JJ, Morton IJ (1979) Peripheral vascular resistance and angiotensin II levels during pulsatile and non-pulsatile cardiopulmonary bypass. Thorax 34:594–598

    PubMed  Google Scholar 

  34. Trinkle JK, Helton NE, Wood RE, Bryant LR (1969) Metabolic comparison of a new pulsatile pump and a roller for cardiopulmonary bypass. J Thorac Cardiovasc Surg 58:562–569

    PubMed  Google Scholar 

  35. Wilkens H, Regelson W, Hoffmeister FS (1962) The physiologic importance of pulsatile blood flow. N Engl J Med 267:443–446

    PubMed  Google Scholar 

  36. Wright G, Sanderson JM (1972) Brain damage and mortality in dogs following pulsatile and non-pulsatile blood flow in extracorporeal circulation. Thorax 27:738–747

    PubMed  Google Scholar 

  37. Wüsten B (1979) Biophysics of myocardial perfusion. In: Schaper W (ed) The pathophysiology of myocardial perfusion, chap 7. Elsevier/North-Holland Biomedical Press, Amsterdam, pp 199–244

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Pharmacology, Medical and Biological Research Laboratories, Cassella AG, D-6000, Frankfurt/Main 61, Federal Republic of Germany

    Volker B. Fiedler

Authors
  1. Volker B. Fiedler
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fiedler, V.B. Effects of pulsatile and non-pulsatile perfusion on the isolated canine heart. Res. Exp. Med. 179, 183–198 (1981). https://doi.org/10.1007/BF01851615

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01851615

Key words

Search

Navigation