title: A Model of Anterograde Oxygenated Lung Blood Flow in Acardia.
abstract: In extreme situations such as hyperacute rejection of heart transplant or major heart trauma, heart explantation and extracorporeal membrane oxygenation (ECMO) hemodynamic support might be the only means for survival. In our previous model of acardia, pulmonary artery (PA) was clamped and did not receive any anterograde blood flow. A model of anterograde PA perfusion might be necessary to avoid ischemic pulmonary damage in prolonged ECMO in acardia. The aim of this study was to describe the surgical technique and to determine the feasibility of an anterograde lung perfusion in acardia through the anastomosis of the right internal mammary artery (RIMA) to the PA. A venoarterial cardiopulmonary bypass was established in three pigs (72 ± 2.6 kg) by the transjugular insertion to the caval axis of a double-staged cannula with carotid artery return. Heart was excised and ECMO was established as previously reported. Right internal mammary artery was harvested and after measurement of its output (93.3 ± 5.8 ml/min, representing 2.17% ± 0.15% of total pump flow), it was anastomosed to PA. Right internal mammary artery anastomosis to PA is a feasible, safe, and easy to perform maneuver assuring an anterograde lung perfusion in acardia.
authors.affiliation: From the *Department of Cardiothoracic Surgery, CHU Charleroi, Charleroi, Belgium; and †Department of Experimental Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Marinakis
authors.forename: Marco
authors.initials: M
authors.lastname: Burki
authors.forename: Saad
authors.initials: S
authors.lastname: Abdel-Sayed
authors.forename: Ludwig Karl
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D000818:Animals; D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000379:methods; D004195:Disease Models, Animal; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006084:Graft Rejection / Q000601:surgery; D016027:Heart Transplantation; D006439:Hemodynamics; D008168:Lung / Q000098:blood supply*; D008323:Mammary Arteries / Q000601:surgery*; D011651:Pulmonary Artery / Q000601:surgery*; D013552:Swine