Abstract
Despite the recent spread of the disposable bubble oxygenator markedly facilitating the intracardiac repair, the disc oxygenator has yet been exclusively used for prolonged perfusion. The disc oxygenators commercially available, however, require large quantities of the homologous blood for priming, thus offsetting the advantages of this type.
We have noted that rapid intravenous injecton of the canine blood adequately bubbled with oxygen, causes hypotension. In detailed observation, the homologous blood, particularly its plasma was found to be caused this phenomenon, when bubbled. The degree of hypotension varied with the amount of blood, the grade of bubbling and the individuality. This phenomenon was very mild with the autologous blood.
The human blood was noted to be aggregated, when bubbled with oxygen. It has been evidenced in further study that the bubbled plasma is the chief determinant for the aggregation, and that this is a kind of conglutination reaction. This reaction tended to be increased when the homologous blood was crossed.
The oxygenator presently available, particularly the bubble type, destroys and denatures the blood, which in turn causes conglutination of blood cells. It is very likely in such circumstances that the homologous blood gives chances to activate some of latent serological elements.
For the above, we have attempted to compact the disc oxygenator with shortened spacers and other devices. The unit thus created is equal to the disposable sheet oxygenator in the priming volume, and requires only 0 to 300cc of blood in priming the entire circuit. Our isotopical study has shown that the Haemaccel is an adequate perfusate for prolonged by-pass.
Since this unit has been utilized, the postoperative hemodynamics has been surprisingly stabilized: the so-called homologous blood syndrome has been practically eliminated. This is particularly benefitable in radical repair of Tetralogy of Fallot, valvuIar replacement intracardiac surgery of pulmonic hypotensive cases and infants.
