Perfusion technique for treatment of right heart failure.
A simple heparin-bonded circuit to facilitate a femoral vein to femoral artery shunt for the treatment of right-sided circulatory failure is proposed. Desaturated venous blood is shunted to the left-sided circulation to increase systemic blood pressure at the expense of saturation. The circuit comprised 1/4 inch x 3/32 inch tubing with a paediatric Bio-Medicus centrifugal pump head allowing adequate regulation of flow. Paediatric Bio-Medicus cannulae provide flows between 500 and 2000 ml/min. Measurements of pulmonary artery pressure, central venous pressure, arterial pressure, arterial saturation and cardiac output were recorded. In the four case studies presented, the treatment included unloading of the right ventricle with venous to arterial shunting. Likewise, eight Holstein calves underwent shunt utilization after placement of a left ventricular assist device and induction of right ventricular failure. The future use of this device may be instrumental in aiding the cardiothoracic surgical team in the treatment of right-sided circulatory failure.
Beck
J R
JR
Department of Clinical Perfusion, Columbia Presbyterian Medical Center, New York, NY 10032, USA.
Mongero
L B
LB
Goldstein
D J
DJ
Oz
M C
MC
D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical; D002303:Cardiac Output, Low / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects* / Q000502:physiology; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged