Abstract
Since 1957, through the serial experimental and clinical investigations by Akune and co-workers, various types of assisted circulation have been classified according to indicated pathological states as follows : (R) Assisted Circulation for Right-Sided Heart Failure 1) Selective right ventricular bypass 2) Veno-arterial pumping 3) Partial cardio-pulmonary bypass (PCPB) (L) Assisted Circulation for Left-Sided Heart Failure 1) Selective left ventricular bypass 2) Counterpulsation (CP (A-A)) 3) Combination of R1 and L2 (B) Assisted Circulation for Combined Left- and Right-Sided Heart Failure 1) Total cardio-pulmonary bypass 2) Combination of R and L Although a considerable number of reports about assisted circulation for left- or right-sided heart failure have been appeared in recent years, little work has been done to study assisted circulation for both left- and right-sided heart failure. The purpose of this investigation is to establish such a form of circulatory assist system for both left- and right-sided heart failure that can be employed using peripheral cannulation in the emergency room or even at the bedside. A combined method of counterpulsation and PCPB, (CP(V-A)), would appear to be a suitable circulatory assist system fulfilling the above mentioned conditions, because of the following reasons : 1) CP (A-A) circulatory assist system functions only left ventricular supports, while CP (V-A) does not only left ventricular supports but also right one for the reason of using a PCPB circuit, so that CP (V-A) would be efficacious in both the left- and right-sided heart failure. 2) The left ventricular pressure work load alone can be reduced with CP (A-A), on the other hand, both pressure and volume work loads of the left ventricle would be reduced with CP (V-A), so that the left ventricular function could be more efficiently supported with CP (V-A) than with CP (A-A).
