[Urinary bladder temperature monitoring during cardiopulmonary bypass].
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Biomedical subjects
Publications and source records attributed to F Iwaya.
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Two surgical techniques have been developed in our laboratory to deal with identifiable problems in long-term artificial heart experiments. A right throacotomy is used to deal with problems such as extensive bleeding, which occur in the immediate postoperative stage of the experiment, while a left thoracotomy is used in cases in which the original implantation is preceded by more than one week, since extensive adhesions complicate the right thoracotomy at that stage. Pulmonary problems have been eliminated as primary cause of difficulties after reoperation, but infection remains a serious problem.
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A simple cannula method of partial or total left ventricular bypass, utilizing a roller pump and outflow filter, has been developed and applied clinically. One of three patients with severe cardiac and multisystem failure was pumped with total left ventricular bypass for six days and decannulated with recovery of myocardial function after nine days. These results are encouraging and suggest that a number of patients could be salvaged from temporary cardiac failure with a simple cannula-roller-pump bypass system.
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Transapical left ventricular bypass has been demonstrated in normal sheep and one lamb. Recently, TALVB was applied in 3 clinical cases of cardiac failure, with recovery of myocardial function in one patient after 9 days of bypass (6 days total TALVB). These studies suggest that LV apical cannula-roller pump bypass with low dose heparin anticoagulation and secondary surgery to remove the cannula may salvage some patients now dying of temporary cardiac failure.
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