Pulsatile and nonpulsatile cardiopulmonary bypass: review of a counterproductive controversy.

Pore size, tissue ingrowth, and endothelialization of small-diameter microporous polyurethane vascular prostheses.

https://www.annalsthoracicsurgery.org/article/S0003-4975(10)63539-4/pdf

To pulse or not to pulse.

Postoperative Angiographic Assessment of Modified Blalock-Taussig Shunts Using Expanded Polytetrafluoroethylene (Gore-Tex)

Background Impairment of left ventricular function after cardiopulmonary bypass (CPB) is well recognized, but little is known about the time course of recovery of cardiac function early after separation from CPB. Therefore, recovery of left ventricular function was evaluated early after separation from CPB in patients undergoing coronary artery surgery. The authors tried to determine whether this recovery might be attributed to autoregulation of function by preload. Methods Left ventricular pressure was measured with fluid-filled catheters. Data were digitally recorded during increased pressure induced by elevating the legs. Transgastric short-axis echocardiographic views of the left ventricle were simultaneously recorded on videotape. Systolic function was evaluated with the slope (Ees, mmHg/ml) of the systolic pressure-volume relation. Diastolic function was evaluated with the chamber stiffness constant (Kc, ml sup -1) of the diastolic pressure-volume relation. Cardiac function was assessed before CPB, after termination of CPB, and 5, 10, and 15 min later. Two different separation procedures from CPB were compared: in protocol 1, left ventricular function was documented during the standard procedure (n = 24); in protocol 2, the heart was optimally filled 10 min before separation from CPB (n = 12). Results In protocol 1, Ees was 2.88 +/- 0.21 mmHg/ml (mean +/- SEM) and Kc was 0.012 +/- 0.001 ml sup -1 before CPB. Within 10 min after separation from CPB, Ees increased from 1.10 +/- 0.32 to 2.92 +/- 0.34 (P = 0.001) and Kc decreased from 0.022 +/- 0.002 to 0.011 +/- 0.001 (P = 0.001). The parameters remained stable thereafter. In protocol 2, Ees was 2.92 +/- 0.51 mmHg/ml and Kc was 0.011 +/- 0.002 ml sup -1 before CPB. Depression of systolic and diastolic function was not observed in these patients. At time 0, Ees was 2.46 +/- 0.16 and Kc was 0.012 +/- 0.002. These values remained stable throughout the entire observation period. Conclusions Significant functional recovery was observed early after separation from CPB, which was suggestive of time-dependent changes in both systolic and diastolic left ventricular function induced by preload restoration.

Recovery of systolic and diastolic left ventricular function early after cardiopulmonary bypass.

Coronary Flow Distribution and Dynamics During Continuous and Pulsatile Extracorporeal Circulation in the Pig

https://www.annalsthoracicsurgery.org/article/S0003-4975(10)63263-8/pdf

Changes in the Manufacture of Expanded Microporous Polytetrafluoroethylene: Effects on Patency and Histological Behavior when Used to Replace the Superior Vena Cava

Jay W. Geasling

Papers

Coronary Flow Distribution and Dynamics During Continuous and Pulsatile Extracorporeal Circulation in the Pig

Changes in the Manufacture of Expanded Microporous Polytetrafluoroethylene: Effects on Patency and Histological Behavior when Used to Replace the Superior Vena Cava