Mechanical circulatory assist using heparin-coated tube and roller pump system.

We have invented a mechanical circulatory assist system that uses a heparin-coated tube and a roller pump. Experimental left heart bypass was performed on 13 mongrel dogs for 24 hours without systemic heparinization. There were no significant changes in coagulation variables during the experiment, and pathological examination of internal organs after bypass revealed no evidence of thromboembolism. We applied this assist system to 13 patients who could not be weaned from cardiopulmonary bypass after an open heart operation. Left heart bypass was performed on 7 patients, right heart bypass on 1 patient, combined left and right heart bypass on 2, and venoarterial bypass without oxygenation on 3. Duration of support ranged from 5 hours to 21 days, and the pump flow rate ranged from 0.8 to 3.2 L/min. Eight patients were successfully weaned from this support, and 6 were discharged from the hospital. Examination of the tubes in the assist system revealed excellent antithrombogenicity for at least 3 days without systemic heparinization. There was no evidence of thromboembolism in brain, kidneys, lungs, or other organs. Because of its simplicity and antithrombogenicity, this mechanical assist system is beneficial for patients who cannot be weaned from cardiopulmonary bypass after open heart operations.