CLOSED-CHEST CARDIOPULMONARY BYPASS AND CARDIOPLEGIA - BASIS FOR LESSINVASIVE CARDIAC-SURGERY

Background. We developed a method of closed-chest cardiopulmonary bypa ss to arrest and protect the heart with cardioplegic solution. This me thod was used in 54 dogs and the results were retrospectively analyzed . Methods. Bypass cannulas were placed in the right femoral vessels. A balloon occlusion catheter was passed via tile left femoral artery an d positioned in the ascending aorta. A pulmonary artery vent was place d via the jugular vein. In 17 of the dogs retrograde cardioplegia was provided with a percutaneous coronary sinus catheter. Results. Cardiop ulmonary bypass time was 111 +/- 27 minutes (mean +/- standard deviati on) and cardiac arrest time was 66 +/- 21 minutes, Preoperative cardia c outputs were 2.9 +/- 0.70 L/min and postoperative outputs were 2.9 /- 0.65 L/min (p = not significant). Twenty-one-French and 23F femoral arterial cannulas that allowed coaxial placement of the ascending aor tic balloon catheter were tested in 3 male calves. Line pressures were higher, but not clinically limiting, with the balloon catheter placed coaxially. Conclusions. Adequate cardiopulmonary bypass and cardiople gia can be achieved in the dog without opening the chest facilitating less invasive cardiac operations. A human clinical trial is in progres s. (C) 1997 by The Society of Thoracic Surgeons.