The Annals of Thoracic Surgery, Vol 24, 162-169, Copyright © 1977 by The Society of Thoracic Surgeons
Feasibility of closed-chest left ventricular bypass using unilateral retrograde transpulmonary flow
AC Kralios
A method for closed-chest left heart bypass using retrograde unilateral
transpulmonry blood flow originating from the left atrium and retrieved by
a cuffed cannula wedged in a pulmonary artery branch is described.
Technical feasibility and physiological implications were tested in 12
anesthetized sheep and 4 awake calves. Retrograde transpulmonary flow
showed a curvilinear relationship to the left atrial pressure, with the
highest rate of rise occurring when left atrial pressure approached levels
of pulmonary edema (25 to 35 mm Hg); at this point retrograde
transpulmonary flow became equal to control cardiac output. The
intervention and the bypass were well tolerated for short periods by these
healthy animals. The possible advantages of the method are discussed, with
emphasis on self-regulation of bypass flow by the filling resistance of the
left ventricle.
