抄録
A new device of pneumatic driven pulsatile pump was applied for cardiopulmonary bypass in 50 cases of adult valvular disease. In order to obtain good hemodynamics, optimal driving conditions and cannula resistance were measured by mock test.
Pressure gradient across aortic cannula was measured in 4 different sizes of cannula. It was found that the pressure gradient was much higher in smaller size of cannula (5.5, 6.5mm), therefore, aortic pressure did not reach over 100mmHg even though driving pressure increased up to 0.5Kg/cm2.
Aortic cannula for adult patient in pulsatile perfusion should be selected larger than 8.0mm in diameter in order to maintain adequate blood pressure of higher than 100mmHg. (Fig. 2)
The direction of tip of aortic cannula gave much influence to aortic pressure wave form. When tip of cannula was twisted in certain degree against aortic wall, resistance increased in cannula tip, and pressure wave form became distorted. (Fig. 4)
Fig. 5 shows the clinical cases of pulsatile perfusion in different types of aortic cannula.
The optimal driving conditions and the optimal size of aortic cannula were decided by the mock test. (Fig. 6).
The administration of vasodilator markedly influenced to the hemodynamics. Peripheral circulation was well corrected in a few minutes after the administration of this agent. (Fig. 7)
In order to obtain good hemodynamics during pulsatile perfusion, both mechanical control of optimal pump drive and physical control in peripheral circulation were most important.
