Reducation of the Utilization of the Heart by Left Heart Bypass

Dennis, Clarence; Hall, David P.; Moreno, Juan R.; Senning, Å

doi:10.1161/01.res.10.3.298

Cited by 134 publications

(23 citation statements)

References 4 publications

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“…index. Very similar results were reported by Dennis et al 1 The observations suggest that a reduction in the volume load of the left ventricle should have beneficial results clinically and is, indeed, "resting" the heart.1"…”

Section: Discussionsupporting

confidence: 75%

Effects of a Selective Bypass of the Left Ventricle

et al. 1963

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IN A SERIES of articles in 1962, Dennis,'Senning,2 Hall,3 and Moreno4 described a method by which the left ventricle could be bypassed without thoracotoiny. A cannula passed down the right internal jugular vein perforates the atrial septunm and enters the left atrium; a simple circuit then allows left atrial blood to be pumped to the femoral artery. This method of reducing the work of the left ventricle has obvious possibilities of being clinically useful. This is a report of an investigation into the effects of such a bypass on circulatory dynamics and nmyocardial metabolism. Attempts to assess its value in experimental coronary shock and following aortic valvular operations are also reported.Methods Forty-five mongrel dogs (11 to 32 Kg.) were anesthetized with Pentothal, atropine, and nitrous oxide. Both pleural cavities were entered via short intereostal incisions. Pressures were nionitored in the ascending aorta, the right atrium, the pulmonary artery, and the left atrium. The arterial pressures were transmiiitted via strain-gauge transducers to a Grass four-channel recorder on which the dye curves and electrocardiogram were also recorded. The atrial pressures were monitored on saline manomiieters. All pressures were standardized to a level of 10 em. above the operating table.5 Esophageal temperature was kept between 36 and 39 C. by means of a controlled temperature blanket beneath the dog and a heat exchanger in the arterial line. After preliminary dissections were completed, heparin (2 mg./Kg.) was given.Cardiac outputs were estimated by the indicatordilution technique (indocyanine-green dye, Colson densitometer, and three-cycle logarithmic paper). Two curves were used in estimating each output.For right ventricular outputs, the injection site was the superior vena cava and the sampling site the pulmonary artery; for left ventricular outputs,

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Section: Discussionsupporting

confidence: 75%

Effects of a Selective Bypass of the Left Ventricle

et al. 1963

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“…A number of techniques have been described to reduce the left ventricular afterload and to improve blood flow and pressure in the distal aorta including medication, internal [17][18][19] and external aortic shunts [20,21], left ventricular apex-to-aortic shunt [22], and left heart bypass [23]. Intra-aortic shunting was briefly described by Hufnagel in 1949 [17].…”

Section: Discussionmentioning

confidence: 99%

An Intra-Aortic Shunt Prevents Paralysis During Aortic Surgery in Sheep

Lehr

Coe

2007

Journal of Surgical Research

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“…Consequently, with this reduction in diastolic volume, there is a resultant decrease in left ventricular systolic size, wall stress, and myocardial oxygen consumption. Experiments in dogs by Dennis et al [16] demonstrated that left heart bypass could reduce myocardial oxygen consumption by as much as 50%. Axelrod et a1 [17], using the current technique, demonstrated a decrease in left atrial, pulmonary artery diastolic, pulmonary artery mean, and mean systemic arterial pressures of 63, 34, 32, and 29%, respectively.…”

Section: Comparison With Other Percutaneous Cardiopulmonary Bypass Tementioning

confidence: 99%

Percutaneous left atrial to femoral arterial bypass pumping for circulatory support in high‐risk coronary angioplasty

Glassman

Chinitz

Levite

et al. 1993

Cathet. Cardiovasc. Diagn.

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Left atrial to femoral arterial bypass was evaluated as a means of supporting patients who were considered to be at high risk for the performance of percutaneous transluminal coronary angioplasty. A 20 French drainage catheter was inserted percutaneously into the left atrium via a modified transseptal technique. Blood was withdrawn from the left atrium and returned through a femoral arterial cannula using a roller pump. Thirteen patients were treated in this fashion with excellent circulatory support. Pump flows varied from 1.5 to 3 liters per minute and bypass time ranged from 27 to 106 min (mean = 43 +/- 17). Aortic mean pressure was well supported during balloon inflation. No significant complications were encountered. Neither an oxygenator nor a perfusionist is required. The ability to obtain direct left ventricular decompression offers a major potential advantage. Further evaluation of this technique for the support of such patients is indicated.

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Reducation of the Utilization of the Heart by Left Heart Bypass

Cited by 134 publications

References 4 publications

Effects of a Selective Bypass of the Left Ventricle

Effects of a Selective Bypass of the Left Ventricle

An Intra-Aortic Shunt Prevents Paralysis During Aortic Surgery in Sheep

Percutaneous left atrial to femoral arterial bypass pumping for circulatory support in high‐risk coronary angioplasty

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