title: Effective cross-circulation technique of venoarterial bypass for differential hypoxia condition.
abstract: We examined a new technique of cross-circulation (CC) venoarterial bypass (VAB) with femoral arterial perfusion and superior vena cava drainage through a long femoral venous cannula. Six adult mongrel dogs weighing 15 to 20 kg underwent the CC-VAB with oxygenation after introduction of respiratory failure (RF). The flow of the CC-VAB was maintained at half the level of the control cardiac output, and the hemodynamic parameters were monitored. To evaluate hypoxia in the upper body, the arterial partial pressure of oxygen (PaO2 [mm Hg]) in the carotid artery and the venous saturation of oxygen (SvO2 [%]) in the pulmonary artery were measured during control, RF, standard VAB, and CC-VAB conditions. The PaO2 decreased significantly after the introduction of RF (41.7 +/- 12.4), and it returned to normal levels only after CC-VAB (151.2 +/- 24.5, p < 0.05). The SvO2 during CC-VAB (98.6 +/- 2.1) was significantly higher than that during VAB without CC (53.5 +/- 3.4, p < 0.05). These results suggest that this cross-circulation technique could be applied to patients with differential hypoxia during femoral VAB with oxygenation or percutaneous cardiopulmonary support (PCPS).
authors.affiliation: Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kitamura
authors.forename: M
authors.initials: M
authors.lastname: Shibuya
authors.forename: H
authors.initials: H
authors.lastname: Kurihara
authors.forename: T
authors.initials: T
authors.lastname: Akimoto
authors.forename: M
authors.initials: M
authors.lastname: Endo
authors.forename: H
authors.initials: H
authors.lastname: Koyanagi
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001166:Arteriovenous Shunt, Surgical / Q000592:standards*; D002315:Cardiopulmonary Bypass / Q000379:methods / Q000592:standards*; D002339:Carotid Arteries / Q000502:physiology; D002405:Catheterization, Central Venous; D004285:Dogs; D005112:Extracorporeal Circulation / Q000379:methods / Q000592:standards*; D005263:Femoral Artery / Q000502:physiology; D000860:Hypoxia / Q000503:physiopathology / Q000628:therapy*; D010101:Oxygen Consumption / Q000502:physiology; D010107:Oxygenators, Membrane; D011651:Pulmonary Artery / Q000502:physiology; D014684:Venae Cavae / Q000502:physiology