Approach of the pulmonary valve using right heart bypass and bicaval cannula: experimental study.
OBJECTIVE
To reproduce the surgery for correction of pulmonary valve anomalies using right heart bypass and a new bicaval cuffed venous cannula for minimal access surgery.


METHODS
Fifteen Large-White pigs were used for this study. The standard technique model was established with the first five pigs, the experiment was done with nine animals by sternotomy, and one was submitted to a minimally invasive procedure, but has been excluded of the sample. Bicaval drainage by a single cannula was obtained through the internal jugular vein. The cuffs were inflated to increase blood flow to the machine. The return was established by putting the arterial cannula into the pulmonary artery trunk. Pre-bypass parameters were measured and compared with the parameters during the right bypass: Median Arterial Tension (MAT); Heart Rate (HR); O2 Saturation (SAT O2); end-tidal CO2 measures (etCO2); Temperature (T). The statistical analysis was done comparing the pre-bypass and during bypass values.


RESULTS
Pre-bypass values: MAT: 90.8 mmHg; HR = 101.6 beat/min; O2 SAT = 93.8%; PetCO2 = 28.4 mmHg; T = 36.1 degrees C. During bypass the obtained values were: MAT: 88.1 mmHg; HR = 98.0 beat/min; O2 SAT = 93.1%; PetCO2 = 25.3 mmHg; T = 36.9 degrees C. Comparing the average values between the two abovementioned moments, no significant difference occurred in MAT, HR and O2 SAT; PetCO2 and T presented significant differences.


CONCLUSIONS
The bicaval cuffed venous cannula showed efficient drainage of both venae cavae with appropriate hemodynamic parameters during right bypass allowing access to the pulmonary valve.
Silva
Ana Maria Rochapinto e
AM
Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo - SP. ana.mrp@uol.com.br
Dallan
Luís Augusto Palma
LA
Campagnucci
Valquiria Pelisser
VP
Caruso
José
J
Gandra
Sylvio M Aquino
SM
Rivetti
Luís Antônio
LA
D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002248:Carbon Monoxide / Q000032:analysis; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D002404:Catheterization / Q000295:instrumentation / Q000592:standards; D004195:Disease Models, Animal; D006339:Heart Rate / Q000502:physiology; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010100:Oxygen / Q000097:blood; D011651:Pulmonary Artery / Q000601:surgery; D011664:Pulmonary Valve / Q000002:abnormalities / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000601:surgery*; D013552:Swine; D013997:Time Factors
D002248:Carbon Monoxide; D010100:Oxygen