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Biomedical subjects

S Kawada

Publications and source records attributed to S Kawada.

257 records · Page 15Linked to original sources

Efficiency of an air filter at the drainage site in a closed circuit with a centrifugal blood pump: an in vitro study.

In a closed circuit with a centrifugal blood pump, one of the serious obstacles to clinical application is sucking of air bubbles into the drainage circuit. The goal of this study was to investigate the efficiency of an air filter at the drainage site. We used whole bovine blood and the experimental circuit consisted of a drainage circuit, two air filters, a centrifugal blood pump, a membrane oxygenator, a return circuit, and a reservoir. Air was injected into the drainage circuit with a roller pump, and the number and size of air bubbles were measured. The air filter at the drainage site could remove the air bubbles (>40 microm) by itself, but adding a vacuum removed more bubbles (>40 microm) than without vacuum. Our results suggest that an air filter at the drainage site could effectively remove air bubbles, and that adding the filter in a closed circuit with a centrifugal blood pump would be safer.

Animals↗

Multiple primary left ventricular myxomas with multiple intraventricular recurrences.

A 23-year-old male was operated on for two primary left ventricular myxomas of the "complex" type. Ten months later, abnormal echo reappeared and reoperation was carried out to excise 2 recurrent myxomas in the left ventricle. Multiple foci were most likely responsible for the recurrence. No recurrence has been detected for 20 months postoperatively. This may be the first reported case of multiple primary left ventricular myxoma with multiple recurrences in the left ventricular cavity.

Adult↗

Experimental study of extraaortic balloon counterpulsation as a bridge to other mechanical assists.

A special extraaortic balloon was developed that can be placed around the ascending aorta. This balloon can easily support the heart temporarily in a median sternotomy field, especially in cases in which it is difficult to use intraaortic balloon pumping because of peripheral arterial disease. The goal of this study was to judge the applicability of this extraaortic balloon counterpulsation. An extraaortic balloon was placed around the ascending aorta of eight adult canines. Two heart failure models were used in this study: group A-moderate heart failure; group B-severe heart failure. In group A, the aortic systolic pressure was significantly reduced (9.3%, p < 0.01), but in group B, there was no significant change. In group A, there was a significant increase in cardiac output (12.0%, p < 0.01), but in group B, there was no significant change. The endocardial viability ratio in both groups significantly increased (group A: 11.3%, p < 0.01; group B: 11.9%, p < 0.05). An extraaortic balloon around the ascending aorta is easily applicable through a median sternotomy, and can be used as a bridge to more powerful mechanical assists when intraaortic balloon pumping cannot be used.

Animals↗

Experimental study of combination of extraaortic balloon counterpulsation and ventricular assist cup to acute heart failure in dogs.

The goal of this study is to evaluate the applicability and effectiveness of combination support of the extraaortic balloon (EAB) and the ventricular assist cup (VAC) to the acute heart failure model. Under general anesthesia, 10 adult dogs were used. Through the median sternotomy, EAB was placed around the ascending aorta and VAC in the pericardial cavity. After heart failure was induced by administration of propranolol, the on-off tests of devices were done as follows. Only EAB was used, and only VAC was used and both devices were used. Regional blood flows (RBFs) of both ventricles, liver kidneys, and brain were measured by colored microsphere technique. Hemodynamic parameters were also measured. In heart failure model, cardiac output (CO) decreased to 66% of control value. In the group assisted by EAB, aortic peak-diastolic pressure and RBFs of both ventricle and brain increased significantly. In the group assisted by VAC, CO and RBFs of all but the left ventricle significantly increased. In the group assisted by EAB and VAC, aortic peak-diastolic pressure, CO, and all five RBFs significantly increased. These results suggest the combination of EAB and VAC is applicable and effective and would be a promising implantable device for the chronic heart failure.

Acute Disease↗

Video assisted thoracoscopic and cardioscopic radiofrequency Maze ablation.

The authors examined the feasibility of transthoracic radio frequency Maze ablation of atrial fibrillation using video assisted thoracoscopy and cardioscopy in the experimental setting of a beating porcine heart. In six pigs under general anesthesia, the left atrium was viewed using a video assisted thoracoscopy system (VATS), and radiofrequency linear ablation of the left atrial wall was carried out using a radiofrequency ablation catheter (HAT200S:OSYPKA) inserted through a trocar port. The right atrium was also ablated in the same manner under VATS. In six other pigs, intravenous radiofrequency ablation by cardioscopic catheter device was carried out. Atrial fibrillation was provoked by acetylcholine injection plus rapid atrial pacing. The thoracoscopic visual field created for radiofrequency catheter ablation from a transthoracic approach and the cardioscopic visual field from an intravenous approach were sufficient, and safe positioning of the ablation catheter device on the atrial epicardium and endocardium, which enabled linear ablation of the atrium, was obtained. The Optimal setting for ablation was 70-80 degrees C/ 30 sec duration per each ablation. This process was monitored and documented by a video system through the thoracoscope and cardioscope, and results were confirmed by postmortem macrohistologic examination. In conclusion, the authors' results suggest the potential usefulness of the combination of transthoracic radiofrequency catheter ablation with video assisted thoracoscopic and cardioscopic linear ablation of atrial fibrillation, and the possibility that use of this system might eliminate the need for open heart Maze surgery.

Acetylcholine↗