|
|
||||||||
Ann Thorac Surg 1985;39:329-335
© 1985 The Society of Thoracic Surgeons
Divisions of Cardiovascular Surgery, St. Michael's Hospital and the Toronto General Hospital, The University of Toronto, Toronto, Ont, Canada
Accepted for publication June 20, 1984.
* Address reprint requests to Dr. Salerno, St. Michael's Hospital, 30 Bond St, Toronto, Ont, Canada M5B 1W8
The efficacy of pulmonary artery balloon counterpulsation (PABC) was evaluated in improving right ventricular (RV) output during left heart bypass for global cardiac failure. In 13 pigs, a 40-ml balloon was positioned within a graft anastomosed to the pulmonary artery distal to the pulmonary valve, and left heart bypass was instituted from the left atrium to the carotid artery. Global myocardial failure was produced by an infusion of propranolol (range, 25 to 78 mg). In this model, RV output decreased despite volume loading to a right atrial pressure of 15 mm Hg and atrioventricular sequential pacing at 100 beats per minute. Pulmonary artery balloon counterpulsation increased both RV output (from 519 ± 76 to 1,117 ± 110 ml/min; p < 0.01) and RV systolic stroke work (from 1.3 ± 0.4 to 2.3 ± 0.6 gm-m; p < 0.01). Right atrial pressure decreased (from 15.5 ± 0.9 to 10.7 ± 1.0 mm Hg; p < 0.01) in 8 of the pigs studied during RV failure. In 5 pigs, ventricular fibrillation occurred without a stable model of RV failure, and there was no cardiac output before or after counterpulsation. The mechanism of action of PABC was studied by placing a flow probe around a large branch of the right pulmonary artery. During RV failure, balloon inflation caused flow through the pulmonary circulation, and ventricular systole resulted in filling of the graft. During ventricular fibrillation, balloon inflation and deflation produced only a to-and-fro movement of blood in the pulmonary artery branch without net forward flow. These results suggest that PABC may be effective in the treatment of RV failure during left heart bypass if ventricular fibrillation does not occur.
This article has been cited by other articles:
![]() |
P. D. Skillington, G. S. Couper, P. S. Peigh, D. Fitzgerald, and L. H. Cohn Pulmonary artery balloon counterpulsation for intraoperative right ventricular failure Ann. Thorac. Surg., April 1, 1991; 51(4): 658 - 660. [Abstract] [PDF] |
||||
![]() |
D. M. Rose, M. Connolly, J. N. Cunningham Jr, and F. C. Spencer Technique and results with a roller pump left and right heart assist device Ann. Thorac. Surg., January 1, 1989; 47(1): 124 - 129. [Abstract] [PDF] |
||||
![]() |
P. A. Spence, C. M. Peniston, N. Mihic, A. K. Jabr, and T. A. Salerno A Rational Approach to the Selection of an Assist Device for the Failing Right Ventricle Ann. Thorac. Surg., June 1, 1986; 41(6): 606 - 608. [Abstract] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |