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[in Japanese]
1984 Volume 13 Issue 1 Pages
1
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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M. UMEZU, K. KAWAZOE, T. TANAKA, N. FUJII, T. FUJITA, T. AKUTSU
1984 Volume 13 Issue 1 Pages
3-6
Published: February 15, 1984
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ydrodynamic characteristics of 24 commercially available valves were studied using our pulse duplicator system and effective orifice area (EOA) of each valves was calculated by modified Gorlin's equation. The results were as follows; 1) EOAs of tilting disc valves (SJM, Hall-Kaster, Omni-Science, CC-Björk) and newly-developed bovine pericardial xenografts (Hancock pericard., Mitroflow, Ionescu low profile) were larger than those of Björk-Shiley (B-S) and Ionescu-Shiley (I-S) at both aortic and mitral position. 2) EOAs of porcine xenografts (Carpentier Supra annular, Biocor, MO-Hancock) were larger than those of B-S and I-S at aortic position. 3) These simulation data demonstrated to be high resemblance to human hemodynamics obtained from postoperative catheterization.
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Y. KASAGI, J. WADA, M. YOKOYAMA, H. NAGARA, A. YAMAGUCHI
1984 Volume 13 Issue 1 Pages
7-10
Published: February 15, 1984
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The auther carried out a comparative study of the behaviour of mechanical valves (tilting disc valves) and porcine xenograft valves experimentally and clinically. The experimental study revealed a significant difference between these two types of valves in resistance and regurgitation. Hemodynamic paramoters were examined in isolated mitral valve replacement cases pre and postoperatively. Cardiac index, pulmonary artery wedge pressure, pulmonary artery systolic pressure, left ventricular endodiastolic volume index, left ventricular endosystolic volume index, left ventricular ejection fraction were almost same for both types of valves. The postoperative valve area was determined 1.8cm
2 for tilting disc valve and 1.1cm
2 for porcine xenograft. Carpentier-Edwards valve which was obtained from a pt on re-operation was examined using our valve testing apparatus. The result showed that the biological material was not homogenous. We concluded therefore that xenograft prosthesis are at present not ideal valve prosthesis.
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K. KAWAZOE, H. KASEGAWA, N. AONO, K. OHARA, K. KAKU, T. TOMINO, T. FUJ ...
1984 Volume 13 Issue 1 Pages
11-15
Published: February 15, 1984
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From hemodynamic study ISPX showed superior hemodynamic performance over HX and BS, but there was no difference in postoperative improvement of LVDd and CSA among these valve substitutes. From follow-up data incidence of thromboembolism in HX with routine anticoagulation was appearently higher than ISPX without routine anticoagulation. And endocarditis occured only in xenografts and its incidence of ISFX seemed to be higher especially in early postoperative period. In conclusion, because of hemodynamic and antithrombogenic advantages of ISPX which already surpasses pocine xenograft, its use is highly recomended under riving attention to contamination early after operation.
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S. NAKONO, H. HIROSE, H. MATSUDA, S. SATO, T. SAKAKIBARA, T. HOTTA, S. ...
1984 Volume 13 Issue 1 Pages
16-19
Published: February 15, 1984
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We evaluated clinical and hemodynamic results in the patients undergoing AVR with Bjork-Shiley prosthesis and - propiolactone preserved aortic homocaraft, and MVR with Hancock valve, aortic homogaft, and dura mater valve. We concluded that mechanical valve was the prosthesis of choice in aortic as well as in mitral position.
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T KAZUI, N WATANABE, Y HOSHINO, T SASAKI, S KOMATSU
1984 Volume 13 Issue 1 Pages
20-24
Published: February 15, 1984
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Between 1974 and July 1983, two hundred-forty patients underwent cardiac valve replacement using mechanical valve for aortic position and bioprosthesis for mitral position in this institution. The clinical results of cardiac valve replacement, namely survival rate, thromboembolism, hemorrhage, infection, valve failure, hemolysis, re-replacement and hemodynamics were analyzed in both mechanical and biological valve groups. The satisfactory clinical results were obtained in both groups. The present data suggest that the selection of the cardiac valve prosthesis should be based on the patient's age, sex, the site of valve lesion, social and geographical conditions.
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Y. KAWAUCHI, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...
1984 Volume 13 Issue 1 Pages
25-29
Published: February 15, 1984
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219 patients undergoing valve replacement with Hancock bioprostheses were evaluated. Cumulative follow-up was 877 patient-years (mean 4.3 years). Late mortality was 2.2%/P-Y. The incidence of thromboembolism was 2.5%/P-Y. Primary tissue failure occurred in 4 patients (0.5%/P-Y), but not in the patients older than 45 years old. The valve function of I-S and SJM valve prostheses were analysed with computer during the operation. During tachycardia the mean pressure gradient decreased at the aortic position but increased at the mitral position despite decreasing cardiac output.
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Hideo A., Takashi I., Yasuhiko Y., Shoichi F.
1984 Volume 13 Issue 1 Pages
30-33
Published: February 15, 1984
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From Novenber, 1975 to March 1983, we implanted 275 porcine xenograft in mitral position. 123 cases were Hancock valves and 152 cases were Carpentier-Edwards valves. There were 12 hospital deaths, for a mortality of 4.4%. There were few thromboembolism (3 cases), valve dysfunction (2 cases) and infective endocarditis (one case).
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E. IMAMURA, S. NAKANO, H. OHTEKI, H. NISHIDA, M. ENDO, A. HASHIMOTO, H ...
1984 Volume 13 Issue 1 Pages
34-36
Published: February 15, 1984
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An eight-year follow-Lip study of 604 patients undergoing mitral valve replacement with tilting disc valve and porcine xenograft showed that there was no significant difference in incidence of late mortality and infectious endocardi tis. While the rereplacement rate was twice higher in xenograft, the thromboembolism occurred 3 times more frequently in disc-valve.
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I. YADA, M. KUSAGAWA, S. SHOMURA
1984 Volume 13 Issue 1 Pages
37-40
Published: February 15, 1984
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The early and the late results of mitral valve replacement, knowing which is better compared the mechanical valve prostheses with porcine prostheses, were retrospectively evaluated in 92 patients receiving a Björk-Shiley (B-S) tilting disc prosthesis and 259 patients receiving a porcine bioprosthesis (P-B) between January, 1976, and December, 1982. The groups were comparable with regard to age, sex, New York Heart Association function class and valvular lesion. Operative mortality was 6.5% for the B-S and 8.5% for the P-B group (N. S.). Cumulative duration of follow up was 226 patient-years for the B-S and 672 patient-years for the P-B group. At 3 and 6 years survival were 86%, 85 % for the B-S and 85%, 85% for the P-B group (N. S.). The percentage of event freedom were 95%, 95% for the B-S and 94%, 94% for the P-B group (N. S.). Thromboembohc complications occured at an incidence of 0.4% per patient years for the B-S and 0.7% per patient years for the P-B group (N. S.). Postoperative hemodynamic data and hematological changes with both groups were not significant. From this analysis, it appears that the major advantage of the P-B over the B-S prosthesis is it use in patient in whom long-term anticoagulation is contraindicated.
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Y. KAGAWA, T. HONGO, T. WATANABE, S. KIKUCHI, N. UCHIDA, Y. SHOJI, M. ...
1984 Volume 13 Issue 1 Pages
41-45
Published: February 15, 1984
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Clinical and hemodynamic assessments were carried out. There were no statistical differences in incidence of major thromboembolism between mechanical and xenograft valves. In actuarial survival and event-free rates, as well as in hemodynamics, mechanical valve seemed superior to xenograft valve.
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T. KOZUKUE, S. SUZUKI, T. ARAI
1984 Volume 13 Issue 1 Pages
46-49
Published: February 15, 1984
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The mitral valve replacement for the patients of the mitral regurgitation showed better hemodynamics in the early postoperative phase than the patients of the mitral stenosis. In the mitral stenosis group, the tissue valve (Ionescu-Shiley pericardial valve) was better hemodynamics than the mechanical valves (Björk-Shiley valve and SJM valve).
In comparison of hemodynamic changes by the cardiac pacing method at the long-term postoperative phase, the tissue valve showed the better henodynamics and prosthetic valve function than the mechanical valves. And this results were clear in 29 and 31mm of the valve diameter, but in 27mm of the valve diameter the mechanical valves were slightly better hemodynamics than the tissue valve.
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M. MATSUMORI, M. NISHIWAHI, K. MICHIYAMA, K. SAWADA, N. NISHIYAMA, T. ...
1984 Volume 13 Issue 1 Pages
50-53
Published: February 15, 1984
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After mitral valve replacement the hemodynamic characteristics of the five commercially available prosthetic mitral valves, 12 cases of Starr-Edwards 6520 valve, 13 cases of Björk-Shiley valve, 12 cases of Hancock porcine xenograft, 7 cases of Carpentier-Edwards valve, 3 cases of Ionescu-Shiley valve were studied and compared by Impedance Cardiography in acute stage and cardiac catheterization in chronic stage. In acute stage, bioprosthesis such as Hancock valve, Carpentier-Edwards valve, Ionescu-Shiley valve is hemodynamically superior to mechanical valve. But one month after operation, there is no significant difference in valve function between mechanical valve and bioprosthesis. Three cases of mitral valve replacement using Ionescu-Shiley pericardial xenograft valve showed the best hemodynamic results at rest but on exercise mean diastolic gradient across the prosthesis increased from 4.5mmHg to 25.5mmHg. All of these three cases were assorated with giant left atrium and small left ventricle. In such cases, low profile valve such as Björk-Shiley valve seems to be superior.
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J. HAYASHI, S. OHTANI, T. YOKOSAWA, S. EGUCHI
1984 Volume 13 Issue 1 Pages
54-57
Published: February 15, 1984
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A series of seventy-nine survived patients who underwent mitral valve replacement between October 1976 and December 1982 was reviewed, and clinical and valve function study were performed. Replaced valves consisted of 17 Carpentier-Edwards (C-E), 23 Björk-Shiley (B-S), and 39 St. Jude Medical (SJM) valve prostheses.
Cardiac or valve-related event-free rate for fourth postoperative year was 94% in both C-E and SJM valve, and was 85% in B-S valve. Transvalvular pressure gradient and calculated effective orifice of these three types of valves were the degree to be allowable, and there was no significant difference of hemodynamics among them.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
58-60
Published: February 15, 1984
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[in Japanese], [in Japanese]
1984 Volume 13 Issue 1 Pages
61
Published: February 15, 1984
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Y. KOMOTO, T. KOHMOTO
1984 Volume 13 Issue 1 Pages
63-66
Published: February 15, 1984
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Bias-cut grafts were designed and implanted experimentally using dogs, based on the assumption that bias-cut grafts tended to return to their original porosity in the process of scar contraction. Ideal biological porosity together with thin inner capsule was found over a prolonged period in each series of large and small caliber grafts, leading to the promising line to eliminate a major threat of thickening of the inner capsule.
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T. HASEGAWA, T. SUEDA, J. MURASHITA, K. TAGUCHI
1984 Volume 13 Issue 1 Pages
67-70
Published: February 15, 1984
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Preservation of adequate compliance and flexibility of EPTFE (Expanded Polytetrafluoroethylene) is demanded in use of small arterial surgery in flexion area and assistance artificial heart research. Internal and/or external coating of EPTFE with polyurethane is applied. Experimentally, grafts implanted in abdominal aorta of 15 dogs were almost patient (93%) and covered with pseudointima after about 90 days, especially SEM disclose that polyurethane was firmly infiltrated into interrodal space and untreated surface allowed thin intimal proliferation. However grafts implanted in abdominal vein were occluded after 3 months (67%). Adequate compliance and flexibility prevents collapsing of cannulae for artificial heart revealing no evidence of thromboembolization after 27 day's implantation. Clinical vascular grafts were also patent (89%) although majority were over 50cm length across the joint area and they were strong enough for suture and high pressure blood stream.
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M. HASHIMOTO, T. KAWAKAMI, Y. MITO, T. KOJIMA, [in Japanese], K YASUDA ...
1984 Volume 13 Issue 1 Pages
71-74
Published: February 15, 1984
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In preliminary study where dog femoral arteries were substitued with Gore-Tex (inner diameter, 3.0mm), all grafts were occluded within six weeks after surgery. To obtain better results, a large dose of platlet aggregation inhibitor (Aspirin, Ticlopidine) or a now under-development antithrombin agent (MD-805) was administered before and after surgery. Almost all grafts were found to be patent at antopsy 4-6 weeks after surgery, but their luminal surfaces were not completly endothelial-lined. To promote the formation of endothelial-lined nonthrombogenic luminal surface, autologous endothelial cell seeding of Vascular-D graft (inner diameter 4mm) was performed. In six dogs, both carotid arteries were resected and one was substituted with Vascular-D graft and the other with endothelial cell seeded Vascular-D graft under the adminisration of MD-805. At the sutopsy 4-6 weeks after surgery, seeded grafts were found to have completly endothelial-lined luminal surfaces.
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T. SASAJIMA, Y. KUBO, M. KOKUBO, Y. IZUMI, M. INABA, A. SATO, H. YOSHI ...
1984 Volume 13 Issue 1 Pages
75-78
Published: February 15, 1984
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Two hundred three arterial reconstructions using Dacron prosthesis and Dardik Biograft were performed in 132 cases with aorto-iliac arterial aneurysm or peripheral arterial occlusive disease. Among 203 bypasses, there were 27 late failures. These consisted of 15 intimal hyperplasias at the anastomotic site, 3 scar stiffening constrictions, 1 progress of disease and 8 unknown etiologies. We consider intimal hyperplasia at the anastomotic site is the main cause of late graft failure regardless of vascular materials.
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T. SASAKI, T. KAZUI, S. KOMATSU
1984 Volume 13 Issue 1 Pages
79-83
Published: February 15, 1984
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In 393 consecutive graft implantations, postoperative complications and the prevention of them were studied. Complications after graft implantation include early postoperative complications, such as blood leakage through the wall of the graft, thrombotic occlusion of the graft, and late postoperative complications, such as suture insufficiency, pseudoaneurysm formation and rupture. In early complications, blood leakage was satisfactorily controlled by the selection of a low porosity graft and the use of conventional preclotting technique. It was more thoroughly prevented by the sealing the graft with fibrin glue. Thrombotic occlusion was not seen in the aortic region. Among the grafts for peripheral arteries the PTFE graft showed good patency in the case of femoro-popliteal bypass above the knee. And the treatment with antithrombotic agent was effective in maintaining patency. Complications at the anastomosis site were related to suture material, suture retention and prosthesis healing. Woven Dacron graft was frayed at the cutting edge and it reduced the suture retention power. We prevented this by electric heating of the edge. Complications due to poor healing had been seen in previous cases in which Tetron and Teflon grafts were used, but recently we have not experienced any healing complications.
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H. IJIMA, M. KODAMA, Y. SAKAKIBARA, Y. SOHARA, K. MITSUI, Y. SUZUKI, T ...
1984 Volume 13 Issue 1 Pages
84-87
Published: February 15, 1984
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Twelve recostrutive surgery for femoro-iliac vein occlusive disease and eleven reconstruction for superior vena cava syndrome were made. Nine EPTFE grafts and three autovein were used for femoro-iliac region and all of the grafts for the eleven superior vena cava replacement or bypass were EPTFE. A temporary distal arteriovenous fistula was useful in the venous reconstructive surgery.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
88
Published: February 15, 1984
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S. KOBAYASHI, H. TAKAHASHI, S. TOYAMA, H. NISHIYAMA, H. ITOH, Y. KARIY ...
1984 Volume 13 Issue 1 Pages
89-92
Published: February 15, 1984
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The cause of pulmonary insufficiency during LVB. A LVB system with a pulsatile-flow roller pump has been employed in canine experiments. LVB was performed between left atrium and descending aorta. It has been supposed that the pulmonary circulation was impaired by the collapse of pulmonary vein due to excessive negative pressure on inflow line during LVB. Some improvements to alleviate this excessive negative pressure on inflow line of LVB circuit, has been performed. But, in a few experiments, pulmonary insufficiency was still observed and it was supposed that the collapse of pulmonary vein was still brought about when bypass flow rate increased up to some level and that further studies have to be continued to prevent this excessive negative pressure.
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-evaluation by left ventriculography (LVG) as well as by hemodynamic improvements
T. NAKATANI, H. TAKANO, T. TAENAKA, M. UMEZU, T. TANAKA, T. MATSUDA, H ...
1984 Volume 13 Issue 1 Pages
93-96
Published: February 15, 1984
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Four chronic experiments of LVAD were performed in goats with PHF. PHF was induced by interception of blood supply to the 70-80% of LV free wall. All of them recovered and LVAD was removed. After LVAD was removed, hemodynamic condition was maintained within a permissible level without tachycardia, and LVG was performed in 2 goats. It showed an increase in LV end-diastolic volume (LVEDV) and a decrease in ejection fraction. Akinesis was observed at LV apex. In conclusion, hemodynamic condition might have been reasonably maintained partially by the increased LVEDV, tachycardia, and also by prevention of dyskinesis by LVAD pumping.
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K. MIYAMURA, M. NASU, H. SHIMPO, K. SHIKANO, S. SHOMURA, I. YADA, M. K ...
1984 Volume 13 Issue 1 Pages
97-99
Published: February 15, 1984
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Our solenoid driven left ventricular assist device was tested in vivo using mongrel dogs. We tested five systems, those were, LA-Ao bypass without reservoir bag, LA-Ao bypass with reservoir bag, LA-Ao bypass to failing heart, LA-Ao bypass by centrifugal pump and LV-Ao bypass. In the experiments by the first system, lower bypass flow and higher negative pressure in the blood chamber were observed than in the latter four systems. So we concluded that the volume of the blood chamber of our device was too big for the hearts of dogs, the pulling up speed of the pusher-plate was too fast and the filling pressure was not high enough. If we want to assist the failing left ventricule by LA- Ao bypass using our assist device, we have to change the volume of the blood chamber properly for the recipient hearts, and improve the device and the control units to be able to change the speed during the diastoric phase of the blood chamber.
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H MORIYA, T ITO, A ISHIHARA, H HASHIMOTO, K MABUCHI, N SASADA, H MAEDA
1984 Volume 13 Issue 1 Pages
100-103
Published: February 15, 1984
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The Effect of Right Ventricular Bypass Flow Verocity to Pulmonaly Shunt Ratio Right venticular bypass ere perfomed on canine heart using piston-bellows type pul satile pump and non-pulsatile centrifugal, or screw pumps. Piston-bellows type pump was able to make 2 types flow pattern, one of this, phsical pulsatile flow (flow verocity is 120cm/sec), another one is not phsical (flow verocity is 35cm/sec).Pa02 and Pv02 were measured, and pulmonaly shunt ratio were calculated. It was no significant diffrence among 3 groups on pulmonaly shunt ratio.
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K. NISHIGAKI, H. HIROSE, H. MATSUDA, S. NAKANO, A. OKUDA, S. MAEDA, M. ...
1984 Volume 13 Issue 1 Pages
104-107
Published: February 15, 1984
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Eight mongrel dogs were devided to following two groups. I: with normal heart II: with failing heart underwent diagonal coronary arteries ligation. During bypass RA mean pressure, RV peak pressure and RV output did not change statistically in both groups.
Two-dimensional echocardiograms revealed the increasing of the dimension of RV and the paradoxical movement of IVS. It has been suggested these paradoxical movements may support the right ventricular function during LA-Ao bypass.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
108
Published: February 15, 1984
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H. TAKANO, Y. TAENAKA, T. NAKATANI, M. UMEZU, T. MATSUDA, T. TANAKA, H ...
1984 Volume 13 Issue 1 Pages
109-112
Published: February 15, 1984
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Feasibility of circulatory maintenance with a SAH was studied in goats. SAH is a pulsatile pump inserted between the left atrium (LA) and aorta after removal of both natural ventricles, while a shunt was placed between right atrium and pulmonary artery (PA) using a graft. Provided that pulmonary vascular resistance was in normal range, circulation was well maintained when right atrial pressure was kept above 14mmHg at acute stage, while above 10mmHg at chronic stage. It is speculated that pressure gradient between PA and LA in addition to pump-up effect by SAH through the lung can maintain the normal circulation without the right heart.
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T. IGARI, F. IWAYA, T. ABE, K. TAKANO, M. ANDOU, K. HAGIWARA, M. TANJI ...
1984 Volume 13 Issue 1 Pages
113-116
Published: February 15, 1984
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From our experiences of development of “Thomasu” Total Artificial Heart, we are now going on to develope the “Thomasu” LVAD. Function test using Mock Circulation revealed our 30cc model (for child use) could pump 3.4l/min and 50cc model (for adult use) could pump 5.4l/min. Intrathoracic implantation of our LVAD might be possible according cadaveric fit trial.
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T. NAKAMURA, K. HAYASHI, S. TAKATANI, H. TAKANO, M. UMEZU, Y. TAENAKA, ...
1984 Volume 13 Issue 1 Pages
117-120
Published: February 15, 1984
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As the first stage of developing a permanent left ventricular assist_device (LVAD), a prototype system was developed and evaluated. A pusher-plate type pump was driven by an actuator consisting of a brushless DC motor and a ball screw. Results from in vitro test with a mock circulatory system showed that speed and output capabilities of the system were inadequate because of insufficiency of the motor torque capability. Based on the NIH criteria, it was found that torque capability of 1.76Kg·cm at 3600 revolutions per minute was necessary to obtain adequate system performance.
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F. IWAYA, S. HOSHINO, T. IGARI, H. INOUE, K. TAKANO, T. ABE, M. ANDO, ...
1984 Volume 13 Issue 1 Pages
121-124
Published: February 15, 1984
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Twenty three calves were operated on for total artificial heart replacement using Japanese Thomasu heart. Only three calves survived more than one month and one of these survived 66 days. Causes of death were various such as, valve failure, quick connector failure, air leakage and broken diaphragm. Broken diaphragm was the most serious problem. We were developing a new technique to make a blood diaphragm which was dipped at the position of systole instead of diastole. This method may diminish the stress during systole.
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H. TAKAGI, T. TAKAGI, M. JINNO
1984 Volume 13 Issue 1 Pages
125-128
Published: February 15, 1984
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New TAH has been developed and tested in dogs. This TAH has modified duct ball valves in I-side and pocketless leaflet valves in r-side respectively. The orfice of these inflow valves were much wider than usual as compared to the capacity of the chamber. They were pumped by our feed back type control machine. Results obtained in mock circulation test suggested that the reserved performance and the responce to the changes of the venous pressure were similar to the natural heart. In acute experiments in dogs (10-13kg), circu=lation was maintained normally from deep hypothermia (13-18°C) to hyperthermia (42°C), from 0.1L/min to 1.8L/min of venous return, without any additional adjustment of the control machine.
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S. TAKATANI, T. TANAKA, T. MATSUDA, H. TAKANO, Y. TAENAKA, T. NAKATANI ...
1984 Volume 13 Issue 1 Pages
129-132
Published: February 15, 1984
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Total Artificial Heart Study in Goats. Since December 1982, diaphragm type TAHs were implanted in 10 goats; both surgical and methodological problems in using goats for TAH study have been worked out. Because of difficulty in controlling diaphragm movement and also in estimating pump output when diaphragm pumps are used, pusher-plate type TAHs and a versatile control-drive system were developed. The pumps incorporate Hall effect sensors to continuously provide diaphragm movement; this signal can then be used to compute beat-to-beat pump output as well as to precisely control diaphragm movement. Fitting study in goats and in vitro test showed satisfactory results as compared with design specifications.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
133
Published: February 15, 1984
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K. TSUCHIYA, M. UMEZU, A. WADA
1984 Volume 13 Issue 1 Pages
134-137
Published: February 15, 1984
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Human blood circulation can be regarded as a closed loop for a short period, in which perspiration and dischange of urine can be ignored. Circulation of blood in human body with the autonomic nervous system was modelled by mechanical elements. Still more, this system has a computation part, DEC-PDP-11-03 computer as autonomic nervous system. Blood volume and capacitance of mechanical elements are determined to correspond with a dog weighed about 20kg.
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N. INOU, I. FUJIMASA, K. IMACHI, A. MIYAMOTO, N. TAKIDO, M. NAKAJIMA, ...
1984 Volume 13 Issue 1 Pages
138-141
Published: February 15, 1984
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Quantitative circulatory insufficiency was made by reducing cardiac output of TAH goats. During these experiments, arterial lactate and pyruvate, were sequentially measured. On the otherhand, mathematical models for explaining the behavior of anaerobic metabolism in systemic low flow states were made. Using these models, metabolic behavior of TAH goats was evaluated. We believe that a useful method for determining the application and weaning time of the left ventricular assist device is establised.
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M. UMEZU, H. TAKANO, T. NAKATANI, K. HAYASHI, Y. TAENAKA, T. TANAKA, T ...
1984 Volume 13 Issue 1 Pages
142-145
Published: February 15, 1984
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A high performance automatic bypass flow (BF) control system has been developed for pneumatic type LVAD. The system design is based on the concept of “simultaneous two-level control”, in which two hemodynamic parameters (left atrial pressure & total flow) can be controlled by an automatic variation of BE through LVAD. The change in BE is achieved by electronically varying Fs-values (Fs; systolic duration for LVAD in percentage). The range of Fs and the gain of Fs change can be set at any time by the use of another microcomputer. The application of this control system to chronic animal experiments with induced heart failure demonstrated stable maintenance of hemodynami cs and effective aid of cardiac function.
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M. NAKAJIMA, I. FUJIMASA, K. IMACHI, K. MABUCHI, S. TSUKAGOSHI, A. MIY ...
1984 Volume 13 Issue 1 Pages
146-149
Published: February 15, 1984
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Left and right cardiac output difference was investigated on six cases of artificial heart goats under right output in physiological range and on one case of normal control. In all cases left output was greater than right by 10 to 20% except for one case of severe regurgitation through remnant left ventricle in FTAH. The difference fluctuated in postoperative course and increased when pulsatile left artificial heart pump was changed to nonpulsatile centrifugal pump. These phenomena suggest that the difference is related to physical conditions of the animal. Bronchial-pulmonary shunt was considered to be the cause of the difference.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
150
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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J. SAKURAI, H. MAETA, M. HORI
1984 Volume 13 Issue 1 Pages
151-154
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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In this series of experiment using normal mongrel dogs, we found that the renal artery blood flow/carotid artery blood flow ratio (R/C ratio) was markedly increased by the intraatrial triple balloon pumping (IAtBP), and simultaneously the renal sympathetic nerve activity was decreased by 17%. We conclude that IAtBP has not only the right heart assist effect but also the improving effect of the peripheral circulation through an autonomic nerve reflex, which depressess the sympathetic vasoconstriction.
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M. OKADA, K. YONEDA, N. KUSUMOTO, T. HATTA, H. HORII, K. SHIMIZU, H. I ...
1984 Volume 13 Issue 1 Pages
155-159
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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This study was performed to investigate the effects of IABP for ventricular septal rupture (VSR) due to acute myocardial infarction (AMI). Diastolic augmentation and systolic unloading were confirmed by initiation of IABP. The effect of IABP was only observed in dogs with AMI+VSR whose QP/QS revealed less than 4.5. IABP was employed in 4 patients with VSR and good results were obtained with combined management of IABP and emergency operation.
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M. KAWAUCHI, H. MATSUMOTO, K. ASANO
1984 Volume 13 Issue 1 Pages
160-164
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Since April 1981 to August 1983, 172 vale replacement surgery were undertaken in our University Hospital. In the intra-or early postoperative period (within 72 hours after completion of extracorpuscular circulation), Intraaortic Balloon Pumping was installed in 13 patients ( =7:6; agell-64 years, mean 47years). Eight patients were indicated IABP for unable to wean from extra-corpuscular circulation; two for arrhythmia, six for low output syndrome. Two patients out of eight were discharged alive. Five patients required IABP for low cardiac output postoperativly and four patients survived. Ten patients were able to wean from IABP and seven survived. Three patients died of renal failure and/or respiratory failure. It appeared that not only hemodynamic variables but also general conditions should be considered at the time of weaning from IABP.
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A. HARADA, N. YAMATE, S. TANAKA, M. GOMIBUCHI, M. IKESHITA, S. YAMAUCH ...
1984 Volume 13 Issue 1 Pages
165-168
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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The purpose of this study was to characterize the Right ventricular (RV) performance while varying Left ventriculer (LV) afterload. 10 dogs (25±3.0kg) were subjected to roller pump to esterblish a LV afterload reduction (-30mmHg) by wlchdrawing blood from descending aorta, and a LV pressure overload (+60mmHg) was produced by placing snare on the descending aorta. RV pressure, it's first derivative (dp/dt) and contractile force (Strain gauge, SG) LAP, Aop, LVdp/dt, LVSG, were recorded. All measurements were compared before and after the ligation of the septal perforator. Our experimental results suggested that the detrimental effect on RV function during afterload reduction to LV (IABP) for septal infarction resulted from the influence of ventricular septum.
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N. KABEI, K. TSUCHIYA, Y. SAKURAI
1984 Volume 13 Issue 1 Pages
169-172
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Dynamic pericardium, consisting of two balloons which are inserted into the pericardial cavity, was developed to squeeze out blood from the ventricles which have less or no functions. Biventricular assistance were performed by DP in 8 mongrel dogs with fibrillating hearts for 2 to 8 hours. During the assistance mean aortic pressure was maintained 50 to 70mmHg. After the total assistance was over all ventricles were successufully defibrillated.
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[in Japanese]
1984 Volume 13 Issue 1 Pages
173
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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S. KYO, H. EMOTO, H. YAMANAKA, S. TAKAMOTO, Y. YOKOTE, R. OMOTO, Y. MO ...
1984 Volume 13 Issue 1 Pages
174-177
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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We have already demonstrated that AVCO-MGH Dynamic Patch has beneficial effects for the recovery of the ischemic failing heart. However, its disadvantageous technical difficulty of patch anastomosis to LV must be improved for the clinical use of Dynamic Patch. Newly developed Saitama-Toray Dynamic Patch, the fragile dynamic membrane part is separated from the plastic frame for anastomosis, is designed to have regard especially for easiness and safety in patch anastomosis. Dogs experiment demonstrated that the hemodynamic effects of Saitama-Toray model is comparable to that of AVCO-MGH model in despite of its smaller volume displacement (25ml vs. 13ml).
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H. EMOTO, S. KYO, H. YAMANAKA, S. TAKAMOTO, K. UEDA, Y. YOKOTE, R. OMO ...
1984 Volume 13 Issue 1 Pages
178-182
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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We have already demonstrated that the Dynamic Patch (D-PATCH) is effective for massive myocardial infarction especially when it is conbined to IABP. However, the effect of D-PATCH on the regional myocardial function of the residual LV wall is not known. The segmental function of residual LV wall of dogs determined by sonomicrometer was improved by D-PATCH support. In conculsion, D-PATCH is effective for the salvage of ischemic residual myocardium.
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S. AOMI, T. HIRAYAMA, C. NOZIRI, S. WATANABE, H. KO, K. SEO, M. HACHID ...
1984 Volume 13 Issue 1 Pages
183-186
Published: February 15, 1984
Released on J-STAGE: October 07, 2011
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Venoarterial bypass without oxygenation coated with bydrophilic heparinized polymer (H-PSD) evaluated in ten dogs. In straight polyvinylcloride circuit thrombus was not found macroscopically but by scanned electrone microscope plalelate adhesion, aggregation and thrombus were found. In tygon circuit having difference in level by connector and side arm thrombus was obserbed at connector and side arm macroscopieally, and at pressed portion by roller separation of coating was observed. In nonthrombogenic circuit straight elastic circuit and elastic coating material would be need.
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