1991 Volume 20 Issue 5 Pages 1425-1433
We have newly-developed percutaneous cannula for use in combination with portable cardiopulmonary bypass support to enable quick and easy application during percutaneous transluminal coronary angioplasty (PTCA) and for patients with severe coronary heart disease. A venous cannula (22-16 Fr in diameter, 48 cm in length) was inserted from the femoral vein into the right atrium. The upper length of the tip of the cannula had 25 radial side holes (each 3 mm in diameter). We obtained an adequate blood flow of 3.2-3.5 l/min using an 18 Fr cannula in our clinical cases. An arterial cannula (18-14 Fr in diameter, 11 cm in length) with similar end radial holes was also used. We performed PTCA using cardiopulmonary bypass support for 11 patients, involving 5 patients with unstable angina (UA) and 6 patients with acute myocardial infarction (AMI). We obtained successful dilatation for the obstructive lesions in all 11 patients. The results for the 5 patients with UA were beneficial and 4 of them were discharged from hospital. However, none survived of the 6 patients with AMI all of whom had received urgent PTCA due to shock or cardiac arrest. However, in the cases of AMI, we obtained some improvements in the clinical symptoms during the cardiopulmonary bypass (CBP) procedeure and succeeded to wean three cases from CPB. Percutaneous cardiopulmonary bypass is effective support for PTCA in severe cases and we recommend this method for those at high risk or with severe cardio-respiratory failure.
