Currently two major types of centrifugal pumps are commercially available for ventricular assist: the Biomedicus-cone (Group I) and the Centrimed-impeller pump (now Sarns 3M) (Group II). To compare them for blood trauma and hemolysis, an in-vitro experiment was designed with a Stöckert roller pump as a standard control (Group III). The in-vitro circuit was constructed consisting of a pump head, electromagnetic flow probe, polyvinyl chloride tubing and a reservoir, identical for all groups. Human ACD blood was used for priming and was circulated with a flow rate of 2 L/min for 24 h. Blood samples were taken at 0, 1, 3, 6, 12, and 24 h and zero control values were subtracted from the resulting data per time interval. Among the 16 parameters studied, a highly significant difference in favor of Group I was found for glutamate oxalacetate transaminase (GOT) and lactate dehydrogenase (p less than 0.0001) and for the free plasma hemoglobin (p less than 0.0001) after 12 and 24 h, respectively. The hemolytic index (Allen) again was lowest for group I in contrast to Groups II and III (0.012 versus 0.060 and 1.70) after 24 h. All other parameters studied did not render significant differences between the systems tested. The authors conclude that the Biomedicus pump currently is the least traumatic centrifugal pump for ventricular assist.
Pulmonary thrombendarterectomy was performed in 32 patients (14 men and 18 women; mean age 38 +/- 15 years) with thromboembolic pulmonary hypertension (New York Heart Association stage III: n = 22; stage IV: n = 10). The preoperative arterial pO2 averaged 59 +/- 11 mm Hg; pulmonary vascular resistance (PVR) and mean pressure (MPAP) were increased to 1,045 +/- 430 dyn.s.cm-5 and 53 +/- 12 mm Hg, respectively. The perioperative death rate was 22% (7 of 32). In the 25 survivors the pulmonary hypertension was reduced to a PVR of 194 +/- 75 dys.s.cm-5, MPAP of 28 +/- 6 mm Hg. Subsequent re-examination in 15 patients (NYHA stage I: n = 14, stage II: n = 1) after a mean of 17 +/- 5 months demonstrated an arterial pO2 averaging 92 +/- 6 mm Hg and, in 14 patients, echocardiographically normal right-ventricular volumes and function. The primary success was confirmed in eight patients by haemodynamic measurements. These data indicate that thrombendarterectomy can effectively treat the increased PVR in most patients at all stages of the disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.