A novel coronary active perfusion system using a conventional intra-aortic balloon pump for off-pump coronary artery bypass grafting.
OBJECTIVE
It is important for coronary active perfusion systems to avoid myocardial ischemia during off-pump coronary artery bypass grafting. We have developed a new concept for a perfusion system to pump blood based on changes in helium gas volume. This system uses a conventional intra-aortic balloon pump to activate the perfusion pump. Our study used basic and animal experiments to investigate the most suitable system for coronary perfusion using this new concept.


METHODS
A conventional intra-aortic balloon pump was used to supply power. A device for perfusion was developed with a balloon placed inside a stiff syringe barrel. The device was connected to the helium gas line of the intra-aortic balloon pump. Changes in flow with changes in augmentation level were noted when volumes outside and within the balloon were changed. Six pigs with occlusion of the left anterior descending artery were used for system validation, with monitoring to identify changes in hemodynamics and cardiac enzyme levels.


RESULTS
In the basic experiment, an 80-mL outside volume and 3.0-mL inner volume resulted in the greatest percentage change in flow rate with respect to changes in augmentation. In the animal experiment, the new coronary active perfusion system prevented myocardial ischemia during coronary occlusion.


CONCLUSIONS
We clarified the most suitable method for our new coronary active perfusion system. Using this system, safe anastomosis was consistently performed in animal experiments. Clinically, off-pump coronary artery bypass may potentially be performed more safely and easily using this new system.
Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan. Electronic address: trilogysuiteop1@gmail.com.
Ryuta
R
Kiuchi
Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
Shigeyuki
S
Tomita
Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
Shojiro
S
Yamaguchi
Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
Yuji
Y
Nishida
Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
Hiroshi
H
Ohtake
Department of Environmental and Preventive Medicine, Kanazawa University, Kanazawa, Japan.
Hiroyuki
H
Nakamura
Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
Go
G
Watanabe
D000818:Animals; D001783:Blood Flow Velocity; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation* / Q000379:methods; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000503:physiopathology*; D004195:Disease Models, Animal; D004867:Equipment Design; D006339:Heart Rate; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D010477:Perfusion / Q000295:instrumentation*; D012039:Regional Blood Flow; D013552:Swine; D013997:Time Factors