Taguchi K, Mochizuki T, Miyoshi N, Murashita J, Maruyama T, Nakagaki M, Matsumura M, Tsuchiya T
Trans Am Soc Artif Intern Organs. 1978;24:104-12.
Long-term experiments employing left ventricular or biventricular bypass with local heparinization and blood filtration for up to 48 days was conducted in 51 calves at different flow rates. The principle of flow control obtained was applied to 15 patients in critical cardiac states. An avcothanized extracorporeal circuit consisted of heparin and protamine microperfusion lines, Pall filter, and nonpulsatile pump. Bypass with flow rates at 30--40% of cardiac output was conducted between 3 and 48 days. Survival was obtained in 34 of 36 calves. Bypass with flow rates at 60--80% of cardiac output was associated with 6 deaths in the 10 calves who underwent the procedure. Bypass with flow rates over 90% of cardiac output was often technically difficult and only 2 of 5 calves survived. Hemodynamic changes correlated well with the above results. In clinical cases flow rate was adjusted up to a maximum of 100% of left ventricular blood flow initially and thereafter to 30--40% of cardiac output for chronic support. A total of 15 patients with myocardial infarction, myocarditis and failing cardiac condition post-surgically were supported for 9--172 hrs. Six of the 15 survived. Adequate flow control in ventricular bypass support is important and the regimen developed in experimental studies proved effective clinically.
对51头小牛进行了长期实验，采用左心室或双心室旁路，并进行局部肝素化和血液过滤，持续长达48天，设置了不同的流速。将获得的流量控制原理应用于15例处于危急心脏状态的患者。一个涂有阿维托坦的体外循环装置由肝素和鱼精蛋白微灌注管路、颇尔过滤器和非搏动泵组成。以心输出量的30%至40%的流速进行旁路循环3至48天。36头小牛中有34头存活。在接受该手术的10头小牛中，以心输出量的60%至80%的流速进行旁路循环导致6头死亡。以心输出量超过90%的流速进行旁路循环在技术上往往很困难，5头小牛中只有2头存活。血流动力学变化与上述结果密切相关。在临床病例中，最初将流速调整至最大为左心室血流量的100%，此后调整至心输出量的30%至40%以进行长期支持。共有15例心肌梗死、心肌炎和术后心脏功能衰竭的患者接受了9至172小时的支持。15例中有6例存活。心室旁路支持中充分的流量控制很重要，实验研究中制定的方案在临床上证明是有效的。
