Ws. Peters et al., CLOSED-CHEST CARDIOPULMONARY BYPASS AND CARDIOPLEGIA - BASIS FOR LESSINVASIVE CARDIAC-SURGERY, The Annals of thoracic surgery, 63(6), 1997, pp. 1748-1754
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.