Veno-arterial bypass with a centrifugal pump without an oxygenator during cross clamping the descending thoracic aorta: experimental study and two clinical experiences

• Published in: Jinko Zoki Vol. 20; no. 3; pp. 715 - 720
• Main Authors: IKEUCHI K, KAZUI H, HOSAKA M, KONDO M, OHTA T, NOGAKI H, NAGATA Y, KATO R, TSUCHIOKA. H
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本人工臓器学会 1991; JAPANESE SOCIETY FOR ARTIFICIAL ORGANS
• Subjects: centrifugal pump; thoracic aortic operation; veno-arterial bypass
• ISSN: 0300-0818; 1883-6097
• DOI: 10.11392/jsao1972.20.715

Ten dogs were examined for descending aorta clamping with veno-arterial bypass using a centrifugal pump without an oxygenator. A bypass route was made between the SVC and the femoral artery. A control study by left heart bypass between the left atrium and the femoral artery was done in 5 dogs. Aorta clamping time was set at 2 hours. All dogs survived 1 to 2 weeks and were sacrificed for laboratory data. In the venoarterial bypass group, PaO2 and O2 saturation of perfusion blood were low compared with the left heart bypass group, but there were no complications, and postoperative laboratory data were not significantly different from those of the control group.We experienced 2 clinical cases of descending aortic surgical procedure with simplified veno-arterial bypass during aorta clamping. There were no complications due to this assist circulation, and postoperative courses were uneventful. 下行大動脈遮断中の部分体外循環を, 遠心式血液ポンプを使用し, 血液酸素化装置は用いずに静脈血を環流させるveno-arterialバイパスにて実験的研究を行い, さらに臨床例を経験した。実験では雑種成犬を用い, veno-arterialバイパスを10例, 対照に左心バイパスを5例に行った。大動脈遮断は2時間行い, 遮断中枢側, 末梢側の動脈圧測定, 血液ガス分析を行い, 血清生化学検査値の推移を経時的に測定した。1～2週で犠牲死させ, 肝, 腎の組織虚血の有無を検索した。veno-arterialバイパスの送血血液の酸素飽和度は左心バイパスに比して低値であったが, 術後に対麻痺等の合併症の発生もなく, 血清生化学検査値の推移に差を認めず, 組織学的に虚血変化も認めなかった。臨床例においては胸部下行大動脈手術の2例に, 人工肺を用いない経大腿静脈右房脱血, 大腿動脈送血によるveno-arterialバイパスを補助循環として用い, 術後重篤な合併症もなく経過した。