Abstract
An avcothanized vinyl sheet consisting of a Pall filter®, 2 pressure monitoring lines, 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 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.
Résumé
Nous avons utilisé, pour bypass ventriculaire gauche transapical de longue durée chez 36 veaux et 11 malades, un circuit de vinyl avcothanisé comportant un filtre Pall, 2 lignes d'enregistrement de pression et 2 tubulures d'héparinisation, avec une pompe rotative. Les 31 veaux soumis à un bypass ventriculaire gauche et les 5 veaux en bypass biventriculaire ont survécu 7 semaines, à l'exception de 2 décès par embolie gazeuse accidentelle et de 2 animaux sacrifiés pour infection. Les hémorragies et thromboses ont été prévenues par héparinisation locale pendant 6 jours, suivie d'une anticoagulation per os maintenant le temps de prothrombine à 150–200% de la normale. Onze malades atteints d'affection cardiaque grave et dans un état critique ont été maintenus en bypass ventriculaire gauche ou biventriculaire pendant des temps variables, allant jusqu'à 172 heures. Quatre malades ont guéri; 3 autres ont pu être progressivement sevrés du bypass, mais sont décédés 1–4 mois plus tard.
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Supported in part by Science Research Grants No. 144059, 177353, and 187097 (1976–1977) of Ministry of Education, Japan, and by Artificial Heart Research Fund (1974–1977) of Mitsui Bussan Ltd., Tokyo, Japan.
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Taguchi, K., Murashita, J., Nakagaki, M. et al. Transapical left ventricular bypass with local heparinization for prolonged circulatory support. World J. Surg. 4, 251–255 (1980). https://doi.org/10.1007/BF02393594
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DOI: https://doi.org/10.1007/BF02393594