CARDIOPULMONARY BYPASS USING CENTRIFUGAL PUMP

被引：12

作者：

BERKI, T

GURBUZ, A

ISIK, O

AKKAYA, H

BAYEZID, O

YAKUT, C

机构：

[1] Koşuyolu Heart and Research Center, Istanbul

来源：

VASCULAR SURGERY | 1992年 / 26卷 / 02期

关键词：

D O I：

10.1177/153857449202600207

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Centrifugal pumps are nonocclusive pumps that offer centrifugal blood pumping known as the constrained force vortex principle. Of 2405 open heart procedures, 370 (15.4%) were performed with a centrifugal pump (CP). In the rest of the cases extracorporeal circulation (ECC) was established with conventional roller pump (RP). The operations performed with a CP were: 34 reoperations, 11 ascending aortic aneurysms + coronary artery bypass graft (CABG), 47 multivalve replacements, 125 CABG + left ventricular aneurysmectomies, and 153 CABGs alone. This prospective study consisted of two groups, each group including 50 patients undergoing CABG surgery. In group I ECC was established with a CP and in group II with a conventional RP. The two selected groups of patients were considered to be similar in terms of clinical, hemodynamic, and angiographic data. Hemodynamic study concerned flow rate, systemic vascular resistance (SVR), and urinary output. No difference was found between the CP and RP hemodynamically. Nevertheless, the alteration of the flow rate in response to variation of SVR is accepted as an advantage. As for hemolytic effect during ECC of CP compared with RP: Plasma free hemoglobin, hemotocrit, platelet count, platelet factor 4, and fibrinogen levels, were investigated. These parameters revealed that there was significant hemolysis and trauma to the blood components in the RP group when compared with the CP. (p < 0.05, p < 0.01). There was no significant difference in psychoneurologic complications, but behavioral and sensory disorders were encountered sevenfold more in the RP group. This might be due to spoliation of the tubing set or to microair embolism. Compared with the conventional RP the CP proved to have no hemodynamic advantage. The effects on blood components showed significant trauma to the RP group. Postoperative drainage verified this observation (p < 0.05). In this study the CP appears to be superior to the RP especially in complicated and prolonged ECC.

引用

页码：123 / 134

页数：12

共 27 条

[1]

Lynch M.F., Peterson D., Baker V., Centrifugal blood pumping for open heart surgery, Minn Med, 61, pp. 536-537, (1978)

[2]

Lynch M.F., Hammond R.N., Schimidt W.R., Et al., Kinetic Heart Pumping, (1980)

[3]

Tietz N.W., Fundamentals of Clinical Chemistry, (1987)

[4]

Engelhrdt H., Vogelsang B., Reul H., Hydrodynamical and hemodynamical evaluation of rotary pumps, pp. 76-81, (1988)

[5]

Pennington D.G., Merwavy J.P., Swartz M.T., Et al., Clinical experience with a centrifugal ventricular assist device, Trans Am Soc Artif Intern Organs, 28, pp. 93-99, (1982)

[6]

Rafferty E.H., Ketschka H.D., Wynward M., Et al., Artificial heart: Application of non-pulsatile force-vortex principle, Minn Med, 51, pp. 11-16, (1968)

[7]

Komoda T., Murakami T., Nouso M., Et al., Cardiopulmonary bypass using centrifugal pump: Hemodynamic and hematologic evaluation in 33 clinical cases. J Jpn Assoc, Thorac Surg, 32, pp. 2013-2046, (1984)

[8]

Hoerr H.R., Kraemer M.F., Williams J.L., Et al., In vitro comparison of the blood handling by the constrained vortex and twin roller blood pumps, J Extracorp Technol, 19, pp. 316-321, (1987)

[9]

Oku T., Harasaki H., Smith W., Et al., Hemolysis: A comparative study of four nonpulsatile pumps, ASAIO Trans, 34, pp. 501-504, (1988)

[10]

Demierre D., Maas D., Turina M., Et al., A new in vitro system to determine hemolysis with blood pumps

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