Kamiya Hiroyuki, Watanabe Go, Doi Toshio, Saito Taro, Takahashi Masao, Tomita Shigeyuki, Tukioka Toshihide, Kanamori Taro
Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medicine, Japan.
ASAIO J. 2002 Nov-Dec;48(6):658-64. doi: 10.1097/00002480-200211000-00015.
To avoid myocardial ischemia during off-pump coronary artery bypass, we developed a coronary active perfusion system (CAPS) that perfuses arterial blood to the coronary artery at the diastolic phase of the cardiac cycle by a syringe pump system. We report herein the details and compare CAPS with a passive shunt circuit from the femoral artery (FA shunt), regarding the physiology of the coronary artery. Six pigs were used for this study. After CAPS or FA shunt perfusion was established, coronary flow and coronary pressure were measured. The coronary flows in the native coronary artery, FA shunt perfusion, and CAPS perfusion with syringe pump stroke volume settings ranging from 0.1 to 0.4 ml were 27.2+/-3.0, 4.1+/-1.5, 12.7+/-1.2, 24.8+/-1.9, 33.3+/-1.6, and 42.2+/-1.9 ml/min, respectively. Mean coronary pressures under FA shunt perfusion and CAPS perfusion with stroke settings from 0.1 to 0.4 ml were 23.7+/-4.6, 48.8+/-5.0, 61.3+/-7.5, 70.8+/-5.4, and 82.3+/-5.2 mm Hg, respectively. CAPS had an advantage over the FA shunt regarding coronary flow with safe coronary pressure. Using CAPS, an off-pump coronary artery bypass can be performed safely without myocardial ischemia.
为避免非体外循环冠状动脉搭桥手术期间出现心肌缺血，我们研发了一种冠状动脉主动灌注系统（CAPS），该系统通过注射泵系统在心动周期的舒张期将动脉血灌注至冠状动脉。我们在此报告其详细情况，并就冠状动脉生理学方面将CAPS与股动脉被动分流回路（股动脉分流）进行比较。本研究使用了6头猪。在建立CAPS或股动脉分流灌注后，测量冠状动脉血流和冠状动脉压力。天然冠状动脉、股动脉分流灌注以及注射泵冲程容积设置为0.1至0.4毫升时的CAPS灌注的冠状动脉血流分别为27.2±3.0、4.1±1.5、12.7±1.2、24.8±1.9、33.3±1.6和42.2±1.9毫升/分钟。股动脉分流灌注以及冲程设置为0.1至0.4毫升时的CAPS灌注下的平均冠状动脉压力分别为23.7±4.6、48.8±5.0、61.3±7.5、70.8±5.4和82.3±5.2毫米汞柱。在冠状动脉血流方面，CAPS相对于股动脉分流具有优势，且冠状动脉压力安全。使用CAPS，可以在无心肌缺血的情况下安全地进行非体外循环冠状动脉搭桥手术。
