When feasible, mitral valve repair is the usual treatment of choice for correction of chronic mitral insufficiency. When valve replacement is required, chordal sparing is the preferred technique. Many investigators have pointed out the merits of preserving the subvalvular apparatus during mitral valve replacement. However, many surgeons hesitate to perform chordal-sparing mitral valve replacement because of its technical complexity and potential interference with mechanical valve leaflet motion. We present a modified technique of chordal-sparing mitral valve replacement to avoid these problems.
To improve the ease of driving a centrifugal pump that is afterload dependent, we have developed an automatic flow control system for the Terumo Capiox centrifugal pump system. This system consists of an autoflow cruise control system with a safety cutoff. The Capiox Pump Console 3000 was controlled by a personal computer through a serial communication line. In the usual manual mode, the motor speed knob works as a pump speed control, and in the autoflow mode, the same knob works as a blood flow rate control. After selecting and obtaining the desired flow rate, the mode was changed from manual to autoflow mode. In the autoflow mode, the computer compares the desired flow rate with the actual flow measured by an ultrasonic Doppler flowmeter and adjusts the motor rotational speed accordingly. During both in vivo and in vitro testing, this autoflow mode was able to return the changed flow that was disrupted by either clamping and declamping of the tubing or by the bolus injection of a vasomotor drug to the selected flow rate within 10 s without any significant fluctuation. In conclusion, the newly developed computer controlled autoflow system was able to produce a reliable and effective flow regulation for a centrifugal pump.
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