Abstract
The recent development of direct techniques for coronary revascularization has resulted in a multitude of critically ill patients requiring open-heart surgery. In an effort to deal with the increasing numbers of patients who both require urgent open-heart surgery and present with the many complicated patterns of coronary artery and/or valvular heart disease, a broad spectrum of cardiac assist measures ranging from simple pharmacologic maneuvers to the development of a variety of mechanical cardiac assist techniques have been developed. Those temporary mechanical cardiac assist devices (CAD) that employ the principle of arterial counterpulsation have met with the most consistent clinical success [8]. It is the purpose of this chapter to summarize our clinical experience with both intra-aortic balloon pumping (IABP) and the pulsatile assist device (PAD) in patients requiring open-heart surgery at the Columbia Presbyterian Medical Center.
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References
Abel, R. M., Buckley, M. J., Austen, W. G., Barnett, G. O., Beck, C. H., Jr., Fischer, J. E.: Etiology, incidence and prognosis of renal failure following cardiac operations. J. Thorac Cardiovasc. Surg. 71, 323 (1976)
Alpert, J., Bhaktan, E. K., Gielchinsky, L., Gilbert, L., Brener, B. J., Brief, D. K., Parsonnet, V.: Vascular complications of intraaortic balloon pumping. Arch. Surg. 111, 1190 (1976)
Berger, R. L., Saini, F. K.: Conversion of nonpulsatile cardiopulmonary bypass to pulsatile flow by intra-aortic balloon pumping during myocardial revascularization for cardiogenic shock. Circulation 45/46, Suppl. 2, 130 (1972)
Bolooki, H., Williams, W., Thurer, R. J., Vargas, A., Kaiser, G. A., Mack, F., Ghahramani, A. R.: Clinical and hemodynamic criteria for use of intra-aortic balloon pump (IABP) in cardiac surgery patients. J. Thorac Cardiovasc. Surg. 72, 26 (1976)
Boucher, J. K., Rudy, L. W., Jr., Edmunds, L. H., Jr.: Organ blood flow during pulsatile cardiopulmonary bypass. J. Appl. Physiol. 36, 86(1974)
Bregman, D.: Management of patients undergoing intra-aortic balloon pumping. Heart Lung 3, 916 (1974)
Bregman, D.: Dual chambered intra-aortic balloon counterpulsation, Current Techniques in Extracorporeal Surgery. Ionescu, M. J., Wooler, G. H. (eds.), p. 407. London: Butterworth 1976
Bregman, D.: Mechanical support of the failing heart. In: Current Problems in Surgery. Chicago: Yearbook Medical, December, 1976
Bregman, D., Goetz, R. H.: Clinical experience with a new cardiac assist device — the dual chambered intra-aortic balloon assist. J. Thorac. Cardiovasc. Surg. 62, 577 (1971)
Bregman, D., Goetz, R. H.: A failsafe cardiac assist system for intra-aortic balloon pumping. Trans. Am. Soc. Artif. Inern. Organs 17, 505 (1972)
Bregman, D., Parodi, E. N., Edie, R. N., Bowman, F. O., Jr., Reemtsma, K., Malm, J. R.: Intraoperative unidirectional, intra-aortic balloon pumping in the management of left ventricular power failure. J. Thorac. Cardiovasc. Surg. 70, 1010 (1975)
Bregman, D., Parodi, E. N., Haubert, S. M., Szarnicki, R. N., Spotnitz, H. M., Bowman, F. O., Jr., Reemtsma, K., Malm, J. R.: Counterpulsation with a new pulsatile assist device (PAD) in open-heart surgery. Med. Instrum. 10, 232 (1976)
Bregman, D., Parodi, E. N., Haubert, S. M., Szarnicki, R., Edie, R. N., Spotnitz, H. M., Bowman, F. O., Jr., Reemtsma, K., Malm, J. R.: Unidirectional intra-aortic balloon pumping and counterpulsation during open heart surgery. In: Mechanical support of the failing heart and lungs. Bregman, D. New York: Appleton-Century-Crofts 1977
Bregman, D., Bailin, M., Bowman, F. O., Jr., Parodi, E. N., Haubert, S. M., Edie, R. N., Spotnitz, H. M., Reemtsma, K., Malm, J. R.: A pulsatile assist device (PAD) for improved myocardial protection during cardiopulmonary bypass. Ann. Thorac. Surg, (in press)
Ciardullo, R., Schaff, H. V., Flaherty, H. T., Gott, V. L.: A new method of producing pulsatile flow during cardiopulmonary bypass using a standard roller pump. J. Thorac. Cardiovasc. Surg. 72, 585 (1976)
Ciardullo, R. C., Schaff, H. V., Flaherty, H. T., Gott, V. L.: Myocardial ischemia during cardiopulmonary bypass. The hazards of ventricular fibrillation in the presence of a critical coronary stenosis. J. Thorac. Cardiovasc. Surg. 73, 746 (1977)
Dunn, J., Kirsh, M. M., Harness, J., Carroll, M., Starker, J., Sloan, H.: Hemodynamic, metabolic and hematologic effects of pulsatile cardiopulmonary bypass. J. Thorac. Cardiovasc. Surg. 68, 138 (1974)
Flemma, R. J., Harjeet, M. S., Tector, A. J., Lepley, D., Jr., Gabriel, R. P.: Factors predictive of perioperative myocardial infarction during coronary operations. Ann. Thorac. Surg. 21, 215 (1976)
Furman, S., Whitman, R., Stewart, J., Parker, B., McMullen, M.: Proximity to aortic valve and unidirectionality as prime factors in counterpulsation effectiveness. Trans. Am. Soc. Artif. Intern. Organs 17, 153 (1971)
Galen, R. S., Gambino, S.: Isoenzymes of CPK and LDH in myocardial infarction and certain other diseases, Pathobiol. Annu. by Iochim, H. L. (ed.), p. 283. New York: Appleton-Century-Crofts (1975)
German, J. C., Chalmers, G. S., Hirai, J., Mukherjie, N. D., Wakabayashi, A., Connolly, J. E.: Comparison of nonpulsatile extracorporeal circulation on renal tissue perfusion. Chest 61, 65 (1972)
Goldman, B. S., Gunstensen, J., Gilbert, B. W., Kelly, T. C., Scully, H., Williams, W. G., Adelman, A. G.: Increasing operability and survival with intra-aortic balloon pump assist. Can. J. Surg. 19, 69 (1976)
Goodman, T. A., Gerard, D. F., Bernstein, E. F., Dilley, R. B.: The effects of pulseless perfusion on the distribution of renal cortical blood flow and on renin release. Surgery 80, 31 (1976)
Habal, S., Parodi, E. N., Hanson, B., Wolvek, S., Bregman, D.: A new pulsatile assist device (PAD) for use in cardiac surgery. ASAIO 5, 32 (1976)
Habal, S. M., Weiss, M. B., Spotnitz, H. M., Parodi, E. N., Wolff, M., Cannon, P. J., Hoffman, B. F., Malm, J. R.: Effects of pulsatile and nonpulsatile coronary perfusion on canine left ventricular performance. J. Thorac. Cardiovasc. Surg. 72, 742 (1976)
Harken, A. H.: The influence of pulsatile perfusion on oxygen uptake by isolated canine hind limb. J. Thorac. Cardiovasc. Surg. 70, 237 (1975)
Haubert, S. M., Parodi, E. N., Bregman, D.: Clinical experience with a new pulsatile cardiac assist device. JECT 9, 22 (1977)
Hewitt, R. L., Weichert, R. F.: Diastolic augmentation during heart bypass. J. Thorac. Cardiovasc. Surg. 60, 123 (1973)
Jacobs, L. A., Klopp, F. H., Seamone, W., et al.: Improved organ function during cardiac bypass with a roller pump modified to deliver pulsatile flow. J. Thorac. Cardiovasc. Surg. 58, 703 (1969)
Maddoux, G., Pappas, G., Jenkins, M., Battock, D., Trow, R., Smith, S. D., Jr. Steele, P.: Effect of pulsatile and nonpulsatile flow during cardiopulmonary bypass on left ventricular ejection fraction early after aortocoronary bypass surgery. Am. J. Cardiol. 37, 1000 (1976)
Mandelbaum, I., Burns, W. H.: Pulsatile and nonpulsatile blood flow. JAMA 191, 657 (1965)
Mandelbaum, I., Berry, J., Silbert, M., Burns, W. H., Rothe, C.: Regional blood flow during pulsatile and nonpulsatile perfusion. Arch. Surg. 91, 771 (1965)
Many, M., Soroff, H. S., Birtwell, W. C., Wise, H. M., Deterling, R. A.: The physiologic role of pulsatile and nonpulsatile blood flow. Arch. Surg. 97, 917 (1968)
Matsumoto, T., Wolferth, C. C., Perlman, M. H.: Effects of pulsatile and nonpulsatile perfusion upon cerebral and conjunctive microcirculation in dogs. Am. Surg. 37, 61 (1971)
Milnor, W. R.: Pulsatile blood flow, Physiology in Medicine. Fishman, A. P., (ed.). N. Engl. J. Med. 287, 27–34 (1972)
Morkin, E.: Analysis of pulsatile blood flow and its clinical implications. N. Engl. J. Med. 277, 139 (1967)
Mukherjie, N. D., Beran, A. V., Herai, J., Wakabayashi, A., Sperling, D. R., Taylor, W. F., Connolly, J. E.: In vivo determination of renal tissue oxygenation during pulsatile and nonpulsatile left heart bypass. Ann. Thorac. Surg. 15, 354 (1973)
Nakayama, K., Tamiya, T., Yamamoto, K., Izumi, T., Akimoto, S., Hashizume S., Hmori, T., Odaka, M., Yazawa, C.: High-amplitude pulsatile pump in extra-corporeal circulation with particular reference to hemodynamics. Surgery 54, 798 (1973)
Pappas, G., Winter, S. D., Kopriva, C. J., Steele, P. P.: Improvement of myocardial and other vital organ functions and metabolism with a simple method of pulsatile flow (IABP) during clinical cardiopulmonary bypass. Surgery 77, 34 (1975)
Paquet, K. J.: Hemodynamic studies in normothermic perfusion of the isolated pig kidney with pulsatile and nonpulsatile flows. J. Cardiovasc. Surg. 1, 45 (1969)
Philips, P. A., Bregman, D.: Intraoperative application of intra-aortic balloon pulsation determined by clinical monitoring of the endocardial viability ratio. Ann. Thorac. Surg. 23, 45 (1977)
Sanderson, J. M., Morton, P. G., Tolloczko, T. S., Vennart, T., Wright, G.: The Morton-Keele pump — a hydraulically activated pulsatile pump for use in extracorporeal circulation. Med. Biol. Eng. 1, 182–190 (1973)
Shepard, R. B., Kirklin, J. W.: Relation of pulsatile flow to oxygen consumption and other variables during cardiopulmonary bypass. J. Thorac, Cardiovasc. Surg. 58, 694 (1969)
Tamari, Y., Frantz, S. L., Beil, Ar., Jr., Degnan, T. J., Siedman, S., Garfinkle, T. J., Newman, J. D., Kaplitt, M. J.: Clinical application of intraoperative counterpulsation without balloon pumping. Cardiovasc. Dis. 2, 405 (1975)
Trinkle, J. K., Helton, N. E., Wood, R. E., Bryant, L. R.: Metabolic comparison of a new pulsatile pump and a roller pump for cardiopulmonary bypass. J. Thorac. Cardiovasc. Surg. 58, 562 (1969)
Trinkle, J. K., Helton, N. E., Bryant, L. R., Griffen, W. O.: Pulsatile cardiopulmonary bypass: clinical evaluation. Surgery 68, 1074 (1970)
Verbiski, N., Beckett, F., Jerabek, O., Kolff, W. J.: Pulsatile flow blood pump based on the principle of the Wankel engine. J. Thorac. Cardiovasc. Surg. 57, 753 (1969)
Wesolowski, S. A., Sauvage, L. R., Pinc, R. D.: Extracorporeal circulation: role of the pulse in maintenance of systemic circulation during heart-lung by-pass. Surgery 37, 663–681 (1955).
Wright, G., Sanderson, J. M.: Brain damage and mortality in dogs following pulsatile and nunpul-satile blood flow in extracorporeal circulation. Thorax 27, 738 (1972)
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Bregman, D. (1979). Clinical Experience with Intra-aortic Balloon Pumping and the Pulsatile Assist Device. In: Unger, F. (eds) Assisted Circulation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-67268-2_8
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DOI: https://doi.org/10.1007/978-3-642-67268-2_8
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