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[in Japanese]
1987 Volume 16 Issue 1 Pages
1
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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T. SAKAMOTO, C. K. BEH, S. ENOMOTO, H. ARAI, T. MARUYAMA, M. YANO, A. ...
1987 Volume 16 Issue 1 Pages
3-6
Published: February 15, 1987
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Clinical use of artificial heart as a left ventricular assist devise (LVAD) for 3 patients with profound postoperative heart failure was reported. Progressive secure recovery of myocardial contraction had observed 4th or 5th day after LVAD use, and it was very important to improve the other organ dysfunction due to cardiopulmonary bypass or LOS. To get optimal organ perfusion, we devised and tried “Bisected Diastolic Driving (BDD)” in these cases with renal dysfunction, resulted in marked improvement. On the other hand, left ventricular function curves were calculated by pulse-wave method and were very useful to decide the time of LVAD weaning.
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N. SATO, Y. KAGAWA, M. MIURA, Y. AKINO, M. SADAHIRO, T. WATANABE, Y. S ...
1987 Volume 16 Issue 1 Pages
7-10
Published: February 15, 1987
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Among 6 cases of VAD uses in our institute, successful weaning were done on 4 cases evaluating cardiac functions during VAD uses as follows. In the early phase of p. o. course, evaluation were done during brief interruptions (10-15sec) of VAD. OFF/ON ratio of AOP started from 0.4-0.5 in the first p. o. day and gradually increased up to 0.8 which indicate readiness for weaning off VAD. Afterwards, VAD was stopped temporarily for 10-15min with Heparin 1mg/kg and measurement of CI and PCWP provided further evaluations. Our weaning criteria is CI>2.0l/min/m
2 and PCWP7<20mmHg . Dose response of catecholamines on the function might also be good indicator for cardiac reserve.
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M. SHIONO, T. HASEGAWA, A. MIYAMOTO, S. KITAMURA, S. UMEDA, H. RIKUKAW ...
1987 Volume 16 Issue 1 Pages
11-14
Published: February 15, 1987
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Retrospective analysis was performed in six cases that were applied clinically with left ventricular assist device. LVAD was indicated in 5 patients for CPB weaning and in one patient for postcardiotomy LOS. 5 cases could wean from LVAD, however one patient falled into LVAD dependent. 2 patients died from MOE and 2 from heart failure in 4 cases which could wean from LVAD, and long survival was only one patient. Clinical evaluation of these cases suggested that total cardiac output index should be maintained more than 2.2l/min/m
2 during LVAD assistance. The method and indication for removal of LVAD has not established yet, however these problems might be resolved as the number of clinical cases would increase in the future.
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M. TANJI, S. HOSHINO, F. IWAYA, T. IGARI, K. TAKANO, M. ANDO, T. ABE, ...
1987 Volume 16 Issue 1 Pages
15-18
Published: February 15, 1987
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Two postoperative caces with low cardiac output, syndrome were treated by left ventricular assist device (LVAD). One of them was weaned off from the LVAD successfully and was discharged on the 79th postoperative day. We discussed about problems of timing of the clinical application and thrombus formation during low perfusion of the LVAD.
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R. TOMINAGA, M. YOSHITOSHI, T. ASO, M. MASUDA, H. KOHNO, K. KINOSHITA, ...
1987 Volume 16 Issue 1 Pages
19-22
Published: February 15, 1987
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On October 7, 1985, a 65 year-old man underwent patch closure of the ruptured ventricular septum immediately after he fell into cardiogenic shock due to ventricular septal rupture following acute myocardial infarction. He could not be weaned from CPB inspite of mechanical support of IABP and aggressive medical therapy, so LVAD was inserted. AVCO PBP-20 was used to drive a LVAD pump for 58 hours. Abrupt stoping of the pump due to accidental trigger mistake suggested the necessity of backup system. The patient was weaned from LVAD system on 16th POD, but died 4 hours later with severe LOS and MOP. However heparin was used, a lot of coagula was detected in LV around the prosthetic patch but not in the blood pump and conduits at autopsy. In such a case more strict anticoagulation therapy should be considered.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
23
Published: February 15, 1987
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H. MATSUDA, H. HIROSE, M. OHTANI, T. HIRANAKA, K. TAMURA, K. NISHIGAKI ...
1987 Volume 16 Issue 1 Pages
24-27
Published: February 15, 1987
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A LVAD (20ml) was applied to a 10 y-o boy with single ventricle after Fontan operation with left heart failure. Although the patient was not salvaged, a total 119 hours assist was performed with adequate total circulatory support.
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M. SADAHIRO, Y. KAGAWA, N. SATO, Y. AKINO, M. MIURA, Y. SUZUKI, T. HOR ...
1987 Volume 16 Issue 1 Pages
28-31
Published: February 15, 1987
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Metabolism in respect of oxygen demand and supply relationship during VAD uses were evaluated and compared between a coronary group (2 cases, A-C bypass and VSP closure+LV aneurysmectomy) and a valvular group (2 cases, MVR+TAP and Re-MVR+AVR). Cardiac index (1/min/m
2): 2.43 in coronary group, 3.39 in valvular group respectively (p<0.01), oxygen availability index (ml/min/m
2): 333.6, 506.5 (p<0.001), oxygen consumption index (ml/min/m
2): 107.1, 154.9 (p<0.001) and oxygen extraction ratio (%): 29.9, 30.8 (N. S). Valvular group showed significantly higher level of both oxygen demand and supply than coronary group and was supposed to have compensated for ocult organ failure induced by long lasted congestive heart failure.
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S. ENOMOTO, Chor Khim BEH, H. ARAI, T. MARUYAMA, M. YANO, T. SAKAMOTO, ...
1987 Volume 16 Issue 1 Pages
32-35
Published: February 15, 1987
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To evaluate renal function of the two patients who had weaned from LVAD, we got values of BUN, creatinin, Ccr, CH
2O, FEN
a every six hours and studied how those values changes at iniciation of circulatory assist by LVAD or at weaning from LVAD. We drived LVAD and IABP simultaneously following bisected diastolic driving method. We also considered which index is best to evaluate renal fanction of Ccr, CH
2O, FEN
a, Renal function, LVAD, Bisected diastolic driving, CH
2O, renal blood flow.
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J. SONEDA, T. BAN, Y. OKAMOTO, M. MATSUMOTO, Y. FUJIWARA, K. NISHIMURA ...
1987 Volume 16 Issue 1 Pages
36-39
Published: February 15, 1987
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Isolated use of RVAD is very rare. The RVAD has been applied to two patients in our institutes. One of them is a long-term survivor. Non-synchronizing pumping of the RVAD was significantly effective. The RVAD was successfully weaned at the postoperative 5th day. In this case, it was very likely that overdriving of the RVAD caused secondary pulmonary edema when the systolic pulmonary arterial pressure reached above 50mmHg without excess of mean left atrial pressure over 15mmHg.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
40
Published: February 15, 1987
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K. HAHIWARA, S. HOSHINO, R. MOTOKI, I. HAYASHI, H. YOSHIZU, P. FREED, ...
1987 Volume 16 Issue 1 Pages
41-44
Published: February 15, 1987
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To induce the chronic heart failure in 8 dogs, we implanted 5-7 electrodes in multiple branches of the left coronary artery and partially ligated the main left anterior descending coronary artery immediately distal to the first septal artery. The electrodes were activated sequentially semiweekly by application of 800μA, anodal current to each electrode. Comparison of parameters, measured by Swan-Ganz and Millar catheter before and after current application indicated significant left ventricular impairment in all dogs.
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T. NAKATANI, T. TAKANO, H. NODA, M. UMEZU, S. FUKUDA, M. KINOSHITA, T. ...
1987 Volume 16 Issue 1 Pages
45-48
Published: February 15, 1987
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We have evaluated the therapeutic effect of VAD on BVF in experimental study. BVF was induced by aortic-clamping under normothermia in goats, and LVAD (8 goats) or BVAD (2 goats) was applied. Without the pulmonary hypertension and uncontrollable arrhythmia, LVAD in combination with volume loading could maintain near normal circulation. In case of BVAD, it wss easy to maintain the circulation without volume loading, even when arrhythmia occured. The healing possibility of the failing heart depends upon the severity of myocardial damage suffered before VAD application.
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M. MIURA, Y. KAGAWA, [in Japanese], T. YANBE, Y. AKINO, T. HORIUCHI, N ...
1987 Volume 16 Issue 1 Pages
49-52
Published: February 15, 1987
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Chronic animal experiments were carried out using air driven sac type VAN, developed in our institute. LVAD's were implanted between LA and Ao of 10 goats. Anticoagulation therapy was not performed except for Heparin injection during the operation. Periods of survival ranged from 7 to 78 days with an average of 35.6 days. Main reasons for termination of experiments were thrombus formation in early postoperative period and pannus formation in late period. Although reduction of thrombus formation was achieved through improvements in sac design based on flow visualization technique, postoperative anticoagulation therapy seemed necessary for prosthetic valve and to extend survival periods.
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T. YAMAMOTO, A. YAMAZAKI, T. HASEGAWA, A. MIYAMOTO, M. SHIONO, K. OGAS ...
1987 Volume 16 Issue 1 Pages
53-56
Published: February 15, 1987
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Myocardial blood flow was measured respectively at intact, marginal and infarcted area which were determined by epicardial mapping ECG. Simultaneously the infarct size was estimated by epicardial ECG. Myocardial blood flow in marginal area was significantly increased with LVAD support (counter pulsation mode). Epicardial mapping ECG showed significant reduction in ST-elevation under LVAD assistance. These results suggest that LVAD treatment reduces infarct size by increasing blood flow in jeopardized area in AMI.
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K. SHIOTSU, T. MATSUKI, A. SHIMIZU, T. NAKAO, H. IRIE, T. MURAKAMI, M. ...
1987 Volume 16 Issue 1 Pages
57-62
Published: February 15, 1987
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By injection of 5NNaOH into the myocardium of the left ventricular free wall wo produced myocardial infarction as a left heart failure model. Left heart bypass using left atrial-aortic perfusion with a pusher plate pump which was operated with non-synchronous variable rate was studied using goats. This method was not, effective in terms of left ventricular decompression, but was effective in terms of total circulatory assistance.
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C.M. WEI, M. MATSUOKA, K. TANAKA, M. IMURA, I. YADA, H. YUASA, M. KUSA ...
1987 Volume 16 Issue 1 Pages
63-66
Published: February 15, 1987
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The left heart bypass (LHB) experiments (Left atrium-aorta) were performed in failing hearts of twenty-three mongrel dogs using a centrifugal pump. Coronary sinus blood flow (CSBF), myocardial oxygen consumption (MOC), myocardial blood flow (MBF) and myocardial PO
2, PCO
2, pH were studied before and during LHB. During LHB, the MBF was effectively distributed to important regions of the damaged left ventricular (LV) through auto-regulation mechanism, and the myocardial PO
2, PCO
2, pH were significantly imporved. In conclusion the LHB is a very useful mechanical circulatory assistance to improve local myocardial metabolism during cardiogenic shock.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
67
Published: February 15, 1987
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N. INOUE, T. KAZUI, A. SASAKI, S. KIKUCHI, H. YOKOYAMA, F. OKAMOTO, S. ...
1987 Volume 16 Issue 1 Pages
68-71
Published: February 15, 1987
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Sixteen dogs were subjected to 3 hours of left anterior descending (LAD) occlusion. After release of the occlusion, Group I had 1 hour's reperfusion without LHB, Group II had 1 hour's reperfusion with LHB. Percent change in TTI 1 hour after reperfusion to 3 hour after occlusion were 25.8±14.0% in Group I and 37.9±16.4% in Group II. Percent change in LVMax. dp/dt were 25.8±14.0% in Group I and 47.6±12.7% in Group II (P<0.05) Compared with before occlusion, percent systolic shortening was not recovered 1 hour after reperfusion withn ischemic area in both groups. AN (Area of Necrosis) AR (Area at Risk) were 69.5±14.4% in Group I and 61.4±15.5% in Group II. These results suggest that the effects of LHB on left ventricular assist during reperfusion were not recognized apparently and not in the limitation of myocardial infarct size.
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T. MATSUMOTO, Y. MITAMURA, T. SHIMOOKA, T. MIKAMI
1987 Volume 16 Issue 1 Pages
72-75
Published: February 15, 1987
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To examine the effect of LVAD on the metabolic viability of ischemic myocardium, myocardial pH was continuously measured after coronary occlusion using ISFET pH sensor. In 7 dogs (LVAD group), LVAD was implanted: coronary occlusion (10-20min) and reperfusion (30-60min) were performed first with pump-on and then with pump-off. In 7 dogs (control group), occlusion and reperfusion were repeated without LVAD. In control group, fall rate of pH decreased to 66±7% (SEM) every occlusion due to progressive cellular damage. Contrarily, in LVAD group, fall rate under LVAD-off increased to 174±32% of that under the preceding LVAD-on due to preservation of myocardium by pumping. LVAD is effective for preserving metabolism of ischemic myocardium.
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S. FUKUDA, H. IWATA, I. SAKAKIBARA, T. MATSUDA, R. HAYASHI, H. TAKANO, ...
1987 Volume 16 Issue 1 Pages
76-79
Published: February 15, 1987
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Infection is one of the major complications in artificial heart, which has become to be used as a bridging device to transplantation. Therefore, the immunological state of patients should be fully understood. In this research the frequency of lymphocyte subsets was evaluated for 4 LVAD patients and 4 control patients with A-C bypass, by two-color immunofluorescence flow cytomery using monoclonal antibodies. There is no clear difference in the most lynphocyte subsets, except Ia presenting macrophage. The frequency of Ia presenting macrophage for control patients gradually increased during 28 post operative days, but that for LVAD patients was kept constant throughout the observations. These results indicate that LVAD dose not greatly affect host defense of patients.
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Y. AKINO, Y. KAGAWA, N. SATO, M. MIURA, T. HONGO, S. NITTA, Y. KATAHIR ...
1987 Volume 16 Issue 1 Pages
80-83
Published: February 15, 1987
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Hematological study was done on 5 cases in which VAD were used. Platelet count decreased during first 7 days of VAD pumping (5.2±2.4×10
4/μl) and then increased to near normal value. Platelet count did not change by pump exchange. Antithrombin III (57.9±3.4%) and plasminogen (56.5±14.4%) decreased remarkably in all cases, while prothrombin time (54.5±11.1%), fibrinogen (340±90mg/dl), and FDP (12.2±9.7μg/ml) were within almost normal value.
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EFFECTS OF INTRAAORTIC BALLOON PUMPING AND VENTRICULAR ASSIST DEVICE
C.K. BEH, S. ENOMOTO, H. ARAI, T. MARUYAMA, M. YANO, J. AMANO, T. SAKA ...
1987 Volume 16 Issue 1 Pages
84-87
Published: February 15, 1987
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Fluctuation of platelet count was studied in 71 cases to determine the normal hematological response to platelet consumption and destruction after cardiopulmonary bypass, and the effects of prolonged mechanical circulatory assist. The platelet count fell to -66% on 2-3 POD, recovered to preoperative level by 7-8 POD, and rebounded to +75% by 14 POD before subsiding to preoperative level around 30 POD. The length of CPB did not alter this response, but IABP and VAD support significantly suppressed platelet recovery until their eventual removal. Perioperative thrombocytopenia was associated with LOS, MOF, DIC, septicemia, malnutrition, deep vein thrombosis and massive blood transfusion.
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T. TAKAHAMA, F. KANAI, M. HIRAISHI, K. ONISHI, Z. YAMAZAKI, Y. SUZUKI, ...
1987 Volume 16 Issue 1 Pages
88-91
Published: February 15, 1987
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It was experimentally confirmed that plasma free hemoglobin, during 24 hrs' LVAD performance, remained within lower level in prostacyclin analogue combined with nafamstat mesilate administered group than in heparin administered group as anticoagulant. And negative driving pressure of the LVAD should be kept under 100mmHg.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
92
Published: February 15, 1987
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-Mechanical work of natural heart in chronic experiments-
T. NAKAMURA, K. HAYASHI, J. SEKI, T. NAKATANI, H. NODA, S. FUKUDA, H. ...
1987 Volume 16 Issue 1 Pages
93-96
Published: February 15, 1987
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Bulk and regional mechanics of the left ventricle during cardiac assist were studied by
in vivo chronic experiments on goats. Miniature ultrasonic sensors implanted for the measurement of left ventricular dimensions worked well for 1 month and the long-term feasibility of the ultrasonic displacement meter was confirmed. The wall thickness did not ch4nge during 1-month pumping. Left ventricular volume and regional area (around 1cm
2 on the free wall) in the systolic and diastolic phases showed a tendency to decrease, while the regional mechanical work increased gradually.
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K. KURIHARA, A. YAMAZAKI, T. HASEGAWA, A. MIYAMOTO, M. SHIONO, K. OGAS ...
1987 Volume 16 Issue 1 Pages
97-100
Published: February 15, 1987
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This experimental study was planned for the purpous of demonstrating the effectiveness, especially renal blood flow and renal function of the left venticular assist device in swine. Regional renal blood flow was increased during LVAD assist. Renal cortical blood flow/renal (cortex+medulla) blood flow ratio was increased. So, the unbalance of the renal regional blood flow was repaired. C
H2O and FE
Na resulted in no charge during LVAD assist, but creatinine clearance (C
Cr) was increased during LVAD assist. These results sttggested LVAD assist was effective for acute renal failure with left heart failure.
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S. FUKUDA, H. TAKANO, T. NAKATANI, H. NODA, M. KINOSHITA, T. TANAKA, M ...
1987 Volume 16 Issue 1 Pages
101-104
Published: February 15, 1987
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The long-term effects of LVAD on RV function of normal heart was studied in 5 goats. The results obtained are: 1) No significant changes was found in overall RV hemodynamic parameters, 2) maxRVdp/dt did not change, irrespective of bypass rate and implantation period, and 3) A slight increased tendency of RV stroke volume did not result from dilatation of RV free wall but due to increased RV cavity derived from reduced LV cavity and septum shift. These suggest that the LVAD pumping does not affect the RV function during at least 4 weeks, but it might reduce reserved ability of RV in longer period.
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N. OHKUBO, H. HIROSE, H. MATSUDA, S. NAKANO, R. SHIRAKURA, S. MAEDA, M ...
1987 Volume 16 Issue 1 Pages
105-108
Published: February 15, 1987
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Transmitral flow dynamics was studied with pulsed doppler flowmetry to evaluate diastolic properties of the left ventricle during LVAD support. The ratio of the peak velocity of atrial contraction to that of rapid ventricular filling did not change from control after institution of LVAD, but increased significantly following coronary ligation.
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K. NISHIGAKI, H. HIROSE, H. MATSUDA, S. NAKANO, R. SHIRAKURA, [in Japa ...
1987 Volume 16 Issue 1 Pages
109-112
Published: February 15, 1987
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Hemodynamic effects of right ventricular assist device (RVAD) for right heart failure caused by acute pulmonary artery banding (PAB) were evaluated in 12 mongrel dogs. Bilateral PAB was performed decreasing both pulmonary arterial area to 50%. Non-assisted dogs (n=5) were died within 30 minutes after PAB. Assisted dogs (n=7) were alive for 180 minutes with RVAD placed between right atrium and main PA proximal to PAB. RVAD decreased RV peak pressure, RAP, and RV stroke work significantly, also LAP was restored to pre-value with maintenance of cardiac output.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
113
Published: February 15, 1987
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T. SAKAMOTO, C. K. BEH, H. ARAI, S. ENOMOTO, T. MARUYAMA, A. SUZUKI
1987 Volume 16 Issue 1 Pages
114-117
Published: February 15, 1987
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New driving method for combined use of left ventricular assist device (LVAD) and IABP is reported with experimental evidence and clinical usefulness. The diastolic interval of failing heart is bisected, and LVAD ejects on early half of the diastole, and subsequently the balloon of IABP is inflated on the remained half. In this method, these two assist devices act during the diastole of the heart as a counterpulsation, resulted in best assist efficacy. Meanwhile, renal blood flow does not reduce during BDD experimentally and clinical improvement of renal dysfunction was obtained in 2 cases.
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Y. ORIME, A. YAMAZAKI, A. MIYAMOTO, T. HASEGAWA, M. SHIONO, K. OGASAWA ...
1987 Volume 16 Issue 1 Pages
118-121
Published: February 15, 1987
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New sequential synchronize driving system of IABP and LVAD was developed and it's hemodynamic effectiveness, especially renal circulation, was evaluated, in swine. This system could easily change driving phase (optimal counterpulsation, early diastole, late diastole) and was expected to clinical application. Renal artery flow and regional renal blood flow was decreased by combination optimal counterpulsation mode of IABP and LVAD. This mode was thought to be harmful influence on renal function. But, delay devide combination mode (drived on early diastole and late diastole), using new system, resulted in no change in renal circulation. So, this delay devide combination mode appeared to be mose promising support to not only failed heart, but also renal circulation.
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T. MURAMATSU, A. MIYAMOTO, S. KITAMURA, S. UMEDA, H. RIKUKAWA, M. SHIO ...
1987 Volume 16 Issue 1 Pages
122-125
Published: February 15, 1987
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Comparison of IABP and LVAD was considered from a viewpoint of peripheral circulation. Lactate, pyruvate, SvO
2 and SaO
2 were measured as parameter of peripheral ciculatory disturbance. The stady results as summarized as follow; 1) Because prognosis was bad in cases that high lactate lasted in spite of IABP, limitation was recognized in IABP and LVAD should be indicatet in same cases.
2) Changes of lactate and SvO
2 reflect peripheral circulatory disturbonce and that can be index of prognosis.
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K. EISHI, H. NISHIDA, E. IMAMURA, M. ENDO, M. HASHIMOTO, H. KOYANAGI, ...
1987 Volume 16 Issue 1 Pages
126-129
Published: February 15, 1987
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Between January, 1981 and November, 1985, 38 assist circulations following open heart operations wereperformed. 27 cases of these assist circulations were only venoarterial bypass (VAB group), 6 cases were only left ventricular bypass (LVB group) and 5 cases were left ventricular bypass following double ventricular bypass using the new double ventricular bypass system in preparation for switch to left ventricular bypass (D-LVB group). Succssesful weaning rate and long survival rate of assisted cases for more than 3 hours were as follows; 14.3%, 0% in VAB group, 60%, 20% in LVB group, 80%, 20% in D-LVB group. In the 3 cases survived more than 27 days, the term of assistance was between 2 days and 4 days, IABP was used in all cases, the bypass flow in DVB was about 70ml/kg·min., the bypass flow in LVB was almost 30ml/kg·min. and catecholamin was not large. This new D-LVB system was very effective as assist circulation following open heart operation under the methods above mentioned.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
130
Published: February 15, 1987
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S. MORIOKA, J. NINOMIYA, S. YAMAUCHI, T. SHOJI
1987 Volume 16 Issue 1 Pages
131-134
Published: February 15, 1987
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Hemodynamic property of newly developed balloon pumping system with synchronized blood flow assist was examined in Vifro (mock circulation).
Results are as follows: 1) adequate pulsatile waves were recognized at each heart rate of 80/min, 100/min, 120/min during various blood flow between 0.3l/min and 1.5l/min. 2) Venous pressure didn't effect the maximam. 3) Maximam pressure exceeded 500mmHg during more than 1l/min of pulsatile blood flow assist. Therefore, this system could be acceptable for clinical use after a couple of unresolved problem was settled.
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T. KOTERAZAWA, M. OKADA, S. KOZAWA, K. SHIO, K. NAKAMURA, S. MATSUDA
1987 Volume 16 Issue 1 Pages
135-138
Published: February 15, 1987
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The effects of IABP on renal function were studied in 31 patients with cardiac diseases. Blood and urine samples for the renal function were taken before and during IABP. Patients were dikided into three groups according to the responses within 6 to 12 hours of IABP. In Group I (20 cases) which showed the significant improvement of renal and cardiac function, the values of Ccr, CH
2O, FENa improved to normal range within 6 hours after initiation of IABP, and the value of Renin—angiotensin II—aldosterone recovered within 24 hours. In Group II (3 cases) with improved renal function and impaired cardiac function, these parameters of renal function improved after 12 hours. In Group III (8 cases) with impaired renal as well as cardiac function, there were no improvements in these parameters. In conclusions, IABP was effective therapy for the patients with cardiogenic shock, LOS and renal dysfunction. The patients who showed improvement of renal function within 12 houres after initiation of IABP could be easily weaned from IABP. However, the patients in whom the renal dysfunction persisted beyond 12 hours of IABP, could not be weaned from IABP.
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H. NISHIDA, A. SHIIKAWA, K. EISHI, E. KOU, Y. TOMIZAWA, K. NAKANO, R. ...
1987 Volume 16 Issue 1 Pages
139-143
Published: February 15, 1987
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During the last two years, 4 critical coronary patients undergoing continuous intraaortic balloon pumping (IABP) were transferred to our hospital and underwent emergency cardiac operation. Three patients (1 with acute papillary muscle rupture of 72 years old female and 1 with acute postinfarction ventricular septal perforation of 80 years old female and 1 with postinfarction angina not controlled on medications and IABP complicating left heart failure of 65 years old female) were taken to the operating room shortly after administration and survived. Only 1 patient of old anterior and inferior infarction with unstable angina complicating 14% LVEF died. The transport time was 20 min, 15 min, 3 hours and 15 min respectively, and used instruments were Datascope system 83M in 2, Aries Model-700 in 1 and Kontron Model-10 in 1. The characteristics concerning transportation of currently available 10 types of IABP (Kontron Model-10, K2000, KAAT, Datascope system 83, 83M, 84A, 90, Aries Model-700, Mansfield Model 1300i, 1300m) was compared. The weight was miniaturized from 170.5kg (Kontron Model-10) to 42.5kg (KAAT) but allowance time of internal battery was limited around one hour. So at the time of long distant transportation, outer energy power such as auxiliary battery, AC inverter (from ambulance car or airplane) or portable generator is need. Among them, we considered the use of AC inverter is most practical.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
144
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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J. NINOMIYA, S. YAMAUCHI, H. MORIOKA, T. ASANO, S. TANAKA, T. SHOJI
1987 Volume 16 Issue 1 Pages
145-148
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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Cardiac function and hemodynamics were evaluated in ten dogs with right ventricular infarction assisted by PABP alone (Group II) or PABP with synchronized blood flow (Group III). In group II, PABP decreased CVP, RA pres. and RVEDP significantly and also aortic flow, RV max dp/dt and RV mp were increased. But these parameters didn't return to control values. In group III, each parameter improved remarkably and return to almost control value. Therfore, PABP with synchronized blood flow assist significantly improve acute right ventricular failure (followed by improvement of left ventricular function) and could be effective for severe right ventricular failure.
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J. MIYA, H. MAETA, T. ASAKURA, M. HORI
1987 Volume 16 Issue 1 Pages
149-152
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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In the development of a new assisting device there are two important issues when its efficacy is discussed; selection of optimal parameters for its application and a lineality between the assisting effects and the severity of organ failure. From this standpoint, correlation between assisting effect (i. e. increase in CO) of EPABP and several parameters which indicate the severity of RHF was evaluated separately.
Etiologies of RHF were acute (APH, n=8) and chronic pulmonary hypertension (CPH, n=6), pulmonary (PR, n=7) and tricuspid valve regurgitation (TR, n=6), and acute right ventricular myocardial infarction (AMI, n=5), in which the assisting effects of EPABP have been reported in the previous papers. The correlation values (r) were calculated in the following pairs; increase in CO by EPABP (#CO) vs. decrease in CO (*CO), increase in central venus pressure (*CVP), and increase in pulmonary vascular resistance (*PVR) caused by formation of RHF. The r values between #CO vs. *CO were 0.84, 0.67, 0.55, and 0.87 in the APH, CPH, PR and TR groups, respectively, and those between #CO vs. *CVP were 0.71, 0.91, and 0.79 in the APR, CPH, and AMI groups, respectively. In the APR and CPH groups correlation was also observed between #CO vs. *PVR.
In conclusion, a certain advantage of EPABP for failing right heart was assured by rather high correlation between the severity of RHF, which indicated that in the more severity of RHF, the more assisting effects could be obtained. The most reliable indicator of RHF was esteemed to be a decrease in CO.
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S. KYO, S. TAKAMOTO, H. ASANO, Y. YOKOTE, R. OMOTO
1987 Volume 16 Issue 1 Pages
153-156
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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To assess the clinical effect of diastolic augmentation during IABP on CF, three patients underIABP support were studied within six hours after open heart surgery by TE-2DD. TE-2DD could clearly visualized the anatomy and CF of the left main coronary artery with a small peak velocity in systole (SP) and a large peak velocity in diastole (DP). Average DP was 44.7±29.0 which was remarkably increased by TABP support and the average percent increment of DP was 33.0±7.3% during TABP support. TE-2DD can be a potentially useful diagnostic tool for the evaluation of CF of the ischemic failing heart during mechanical support in closed chest human.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
157
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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T. SHIROYAMA, T. AKANATU, H. FUKMASU
1987 Volume 16 Issue 1 Pages
158-161
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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We have been developing a nutating centrifugal pump as pulsatile and non-pulsatile blood pimp. This pump, so called Tea-Spoon type pump (TS-pump), is about 40% in efficiency. l'e aim at improving its pump efficiency. Model test of 2-dimensional TS-pump showed that a narrow clearance bctwcei, impeller and casing increases efficiency. Pressure profile along the inside wall of annular impeller passage was measured in 3-dimensional prototype TS-pump. Maximum shear stress and velocity profile in the c.learance was estimated by a simplified fubrication theory from the observed pressure distribution along the clearance. This proved that the more narrow clearance else reduces the more shear stress relevant to hemolysis. We undertake testing newly-developed TS-pumps which have narrow clearance, smaller impeller and improved profile of casing.
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S. YAMAMOTO, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...
1987 Volume 16 Issue 1 Pages
162-165
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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We have previously developed a compact centrifugal blood pump directly driven by a miniature DC-servo motor for extracorporeal and cardiac assisted circulation. Through in vitro tests, it has been proved that the semi-open type impeller with inlet and outlet blade angle of respective 20° and 50° is the most adequate with regard to the pump characteristics and the degree of hemolysis. In this report, the effect of the pump casing on the pump performances was evaluated to determine an optimum shape of the pump casing. It was demonstrated that the flow characteristics and the degree of hemolysis of the pump with volute casing were significantly improved at higher region of flow rate compared with those of the pump without volute casing. It was suggested through this study that the optimum design of the blood pump should be made in accordance with the range of flow rate required.
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[in Japanese]
1987 Volume 16 Issue 1 Pages
166
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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K. KOSHIJI, T. UTSUNOMIYA, S. TAKATANI, H. TAKANO, T. NAKATANI, M. KIN ...
1987 Volume 16 Issue 1 Pages
167-170
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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The losses in the tissue when the electromagnetic energy at high frequency is transmitted to a driver of the TAH through intact skin using 2 coils are theoretically analyzed, and also, an expression of the relation between the efficiency and the several parameters of the system is derived from the electric circuit theory. We make experiments in vivo of an energy transmission system designed and manufactured by the above. As the results, the losses are very small in the tissue and are relatively large in the coils. The experiments also succeeded to drive both ventricles of the TAH in vitro and in vivo.
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M. ASANO, I. FUJIMASA, K. IMACHI, [in Japanese], T. CHINZEI, Y. ABE, K ...
1987 Volume 16 Issue 1 Pages
171-174
Published: February 15, 1987
Released on J-STAGE: October 07, 2011
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A new type electrically powered oil-driven artificial heart has been designed and developed. The major characteristics are as follows;1) Silicon oft is powered by two DC MOTORS. 2) Cornpliance chamber is not necessary. 3) An atria and ventricle can be changed to two ventricles 4) So it is a compact and implantable AH. Each system of prototype model was developed and evaluated in vitro testing.
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