J.Jpn. Surg. Soc.. 59(11): 1760-1779, 1959
EXPERIMENTAL AND CLINICAL STUDIES ON DIRECT-VISION INTRACARDIAC SURGERY UTILIZING A ROTATING DISK TYPE RESERVOIR-OXYGENATOR
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Department of Surgery, Niigata University School of Medicine (Director: Prof. Tetsuro SAKAI) Yoichi HIROSE |
Our pump oxygenator consists of a sigmamotor pump and a rotating disk type reservoir-oxygenator. Oxygenator has 59 Teflon coated stainless steeI disk, 0.4 mm in thickness and 12.2 cm in diameter, mounted 0.45 mm apart by stainles steel spacers on a central shaft which is supported horizontally within a silicone coated pyrex glass cylinder, 33 cm in length and 13.3 cm in diameter, by gasketed end plate of stainless steel, likewise treated with silicone resin.
Oxygenator is primed with 1400 cc of fresh heparinized blood. As the blood passes through the cylinder, disks rotate at a rate of 120 revolution per minute exposing a thin film of blood to a mixture of 98.5% of oxygen and 1.5% of carbon dioxide, which is introduced into oxygenator through warming system and then perforated stainless steel tube mounted within cylinder above the disks, with flow rate of 5000 cc per minute.
Tygone tube, polyethylene tube and polyethylene connector are used to connect patient to extracorporeal system.
A pump type suction tip is used to collect and recirculate coronary sinus return blood.
Experiments have done with mongrel adults dogs to evaluate pump oxygenator, with attention to blood pressure, blood oxygen and carbon dioxide, blood pH, hemolysis, platelet and red and white blood cell during extracorporeal circulation.
To evaluate the oxygenating capacity of the oxygenator, also, cow blood and human blood was used.
Mean arterial blood pressures during extracorporeal circulation were 50 to 80 mmHg with flow rate from 40 to 80 cc/kg/min.
Oxygenation by oxygenator was adequate up to flow rate of 2000 to 2500 cc per minute and hemolysis was not excessive and destruction of platelet was moderate.
Thirty clinical direct vision intracardiac operations were performed ultilizing our pump oxygenator.
Thirty cases consit of 14 ventricular septal defects, 4 auricular septal defects, 4 pulmonary stenoses, 2 transpositions of great vessles and 6 other complicated cases.
Twenty cases survived and completely cured by intracardiac direct-vision repair.
Preoperative treatment, preparation for extracorporeal circulation, cardiac bypass and repair of intracardiac anomaly by direct vision and postoperative care were described.
Results of physiological studies of patient during and after extracorporeal circulation, such as blood pressure, blood oxygen and carbon dioxide, blood pH, platelet, hemolysis, blood clotting time and bleeding tendency were described and cause of death was discussed.
(author's abstract)
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