Experimental Study of the Effect on Organic Perfusion in the Cardiopulmonary Bypass Through Femoral Artery-Vein Intubation with Improved Cannulas_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Tao , WEI Xufeng , YI Dinghua

Department of Cardiovascular Surgery, Xijing Hospital, the Fourth Military Medical University, Xi’an 710032, P.R.ChinaCorresponding author: YU Shi-qiang,E-mail: yushiq@fmmu.edu.cn;

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Keywords：

Femoral artery-vein; Cardiopulmonary bypass; Perfusion pressure; Venous pressure

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Objective To compare the perfusion pressure between cardiopulmonary bypass (CPB) through improved intubations of femoral artery-vein and routine identical flow on organic perfusion such as brain, lung, liver, kidney, intestines, etc.. Methods Twenty dogs with body weight from 10-15kg were randomly divided into two groups: thoracoscope group(n=10): CPB was set up by the right femoral artery-vein for completely video assisted cardiac operations; routine thoracotomy group(n=10): CPB was set up by the aorta-caval vein. The perfusion pressure of innominate artery, left common carotid artery, superior mesenteric artery, renal artery, homonymic and opposite side popliteal artery and the pressure of concomitant vein were measured at the following time points: instantly after induction of anesthesia (T1) , before aortic clamping (T2) , fifteen minutes after aortic clamping (T3) , fifteen minutes after aortic opening (T4) , twenty minutes after stop (T5) . The venous blood samples were collected at the preceding time points and venous oxygen saturation (SvO2) were measured. Results There were no significant difference between both groups in arterial perfusion pressure, besides perfusion pressure of homonymic popliteal artery in thoracoscope group was lower than that in routine thoracotomy group (P lt;0. 01) . Before aortic clamping, fifteen minutes after aortic clamping and fifteen minutes after aortic opening, venous pressure of renal vein, superior mesenteric vein, homonymic and opposite side popliteal vein in thoracoscope group were higher than those in routine thoracotomy group (P lt;0. 05) . SvO2 of renal vein, superior mesenteric vein, homonymic and opposite side popliteal vein in thoracoscope group were lower than those in routine thoracotomy group (P lt;0. 05) . Conclusion The improved femoral CPB has a similar perfusion pressure with routine CPB and a higher vein pressure than routine CPB below inferior vena cava after aortic intubations. So this experiment provides theoretical evidence for the organic protection of infants’ thoracoscopic extracorporeal circulation.

Citation： CHEN Tao,WEI Xufeng,YI Dinghua,YANG Jian,XU Xuezeng,WANG Xianyue,YU Shiqiang. Experimental Study of the Effect on Organic Perfusion in the Cardiopulmonary Bypass Through Femoral Artery-Vein Intubation with Improved Cannulas. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(6): 433-. doi: Copy

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6.	段大为，陈德凤，杜鹃，等. 股动、静脉插管体外循环在电视胸腔镜心脏手术中的应用．中国胸心血管外科临床杂志，2005, 12(4): 247-249.
7.	Chang CH, Lin PJ, Chu JJ, et al. Video-assisted cardiac surgery in closure of atrial septal defect. Ann Thorac Surg, 1996, 62(3): 697-701.
8.	Lin PJ, Chang CH, Chu JJ, et al. Minimally invasive cardiac surgical techniques in the closure of ventricular septal defect: an alternative approach. Ann Thorac Surg, 1998, 65(1): 165-169.
9.	俞世强，蔡振杰，程云阁，等. 胸腔镜下室间隔缺损修补术. 中国微创外科杂志，2002, 5 (5) : 263-264.
10.	Stockard JJ, Bickford RG, Schauble JF. Pressure-dependent cerebral ischemia during cardiopulmonary bypass. Neurology, 1973, 23(5): 521-529.

1. 　易定华. 胸腔镜心脏外科进展. 中国心血管病研究杂志，2005, 5 (5) : 325-326.
2. 　俞世强，程云阁，蔡振杰，等. 胸腔镜心脏手术并发症分析. 第四军医大学学报，2003, 24 ( 3) : 263-264.
3. 　段大为，程云阁，张铁柱,等. 胸腔镜心脏手术微创体外循环的建立方法. 心肺血管病杂志，2001, 20 (1) : 32-33.
4. 　段大为，刘维永，朱海龙，等. 电视胸腔镜在小儿心脏手术中的应用. 中国内镜杂志，2003, 9 (8) : 7-11.
5. 　段大为，王晓武. 胸腔镜心脏手术体外循环的建立及心肌保护方法. 生物医学工程与临床，2003, 7(2): 128-129.
6. 　段大为，陈德凤，杜鹃，等. 股动、静脉插管体外循环在电视胸腔镜心脏手术中的应用．中国胸心血管外科临床杂志，2005, 12(4): 247-249.
7. 　Chang CH, Lin PJ, Chu JJ, et al. Video-assisted cardiac surgery in closure of atrial septal defect. Ann Thorac Surg, 1996, 62(3): 697-701.
8. 　Lin PJ, Chang CH, Chu JJ, et al. Minimally invasive cardiac surgical techniques in the closure of ventricular septal defect: an alternative approach. Ann Thorac Surg, 1998, 65(1): 165-169.
9. 　俞世强，蔡振杰，程云阁，等. 胸腔镜下室间隔缺损修补术. 中国微创外科杂志，2002, 5 (5) : 263-264.
10. 　Stockard JJ, Bickford RG, Schauble JF. Pressure-dependent cerebral ischemia during cardiopulmonary bypass. Neurology, 1973, 23(5): 521-529.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Experimental Study of the Effect on Organic Perfusion in the Cardiopulmonary Bypass Through Femoral Artery-Vein Intubation with Improved Cannulas

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