The Journal of Thoracic and Cardiovascular Surgery, Vol 71, 792-799, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Heparinless, oxygenatorless perfusion rewarming following surface- induced deep hypothermia for open-heart surgery
H Mohri, T Ishitoya, G DiBenedetto, EA Hessel 2d, KA Merendino and DH Dillard
To facilitate perfusion rewarming without the use of total body
heparinization or an oxygenator following open-heart correction with
surface hypothermia, we divised a pump circuit. The circuit, totally primed
with 100 c.c. of saline, consists of polyurethane-polyvinyl- graphite (PPG)
coated Tygon tubes (with one end tapered by heat treatment) and a
copper-coil heat exchanger. A roller pump was used to achieve partial
bypass from the left atrium to the ascending aorta with flow rates up to 70
c.c. per kilogram per minute. Experiments in dogs resulted in rapid
rewarming, immediate return of cardiac function, and hematologic
alterations similar to those noted during surface rewarming. The safety of
the method was also demonstrated. Prothrombin time, partial thromboplastin
time, and platelet values returned to control levels upon rewarming, and no
thromboemboli or bleeding problems were noted. Six clinical experiences
were accumulated. Details of the method, hematologic and blood chemical
analyses in dogs, and the first clinical trial in a 3-month-old infant with
transposition of the great vessels are reported.
