PMID: 15226829Mar 1, 1986Paper

Concepts in assisted circulation

Texas Heart Institute Journal
A A LefemineA Delucia

Abstract

Assisted circulation by extracorporeal and extracardiac bypass techniques must be based on the requirements of the heart and of the total body, though these may differ. The cardiac problem in cardiogenic shock is more likely to be a biventricular problem demanding decompression of both sides. Extra pulmonary oxygenation should be avoided because of complexity in long-term use. Principles of assisted circulation may be applied in an extra-thoracic temporary manner or as an intracorporeal long-term device without removal of the heart. We have compared a number of extracorporeal mechanical bypass techniques (left ventricular bypass, left atrial bypass, right atrial plus left ventrical bypass, and right atrial plus left atrial bypass) in dogs at different flow rates with control groups (nitroprusside, metabolic substrates, and no therapy) for survival during and after 4-hour treatment periods in a standard severe myocardial infarction preparation with biventricular failure. The left ventricle was cannulated in a retrograde manner. Right atrial bypass was mixed with oxygenated left ventricular blood before return without oxygenation. Results in 50 dogs revealed that without treatment 20% survived; left ventricular plus right atrial ...Continue Reading

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