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off pump surgery in spite of great advancements in techniques of cardio pulmonary bypass it is still not physiological there can be various
total artificial heart jarvik seven was the first successful total artificial heart supporting the patient for 112 days the disadvantage is that
ventricular assist devices these come handy when iabp has failed or when prolonged circulatory support is needed now ieft ventricular lvad right
complications iabp can compromise blood flow to the leg at the time of insertion pumping or after removal of balloon it may also cause perforation
equipment basically it has an intra aortic balloon pump a balloon with a capacity of 40 ml is passed percutaneously through the femoral artery
contra indication it is absolutely contra indicated if their is more than trivial aortic regurgitation aortic aneurysm and severe aorto iliac
indication iabp is commonly used to supporting failing left ventricle after open-i1ca1-t surgery or in cardiogenic shock after myocardial
circulatory assist devices intra aortic balloon pump iaup was introduced by kantrowitz 19hx it is also known as counter pulsation or diastolic
haemo filtration ultra filtration during open heart surgery helps in removing excess fluid especially in renal failure patients patients are haemo
blood salvage and bloodless open-heart surgery at the time of cardio pulmonary bypass cardiomony suckers suck blood from the chambers or the heart
venting of the heart it is important that heart does not distend during cardio pulmonary bypass this is prevented by venting of the left side of
myocardial protection to a great extent the result of cardiac surgery depends on how well the myocardium is protected during cardio pulmonary
hypothermia hypothermia reduces the metabolic requirements of the body thereby reducing oxygen consumption it also preserves high-energy
open heart surgery when patient is connected lo cardio pulmonary bypass for an operative procedure it is considered to be open-heart operation in a
conduct of perfusion at the beginning of the bypass the pump output is usually kept at 24 litres per meter per minute on coming off bypass the
cannulation typically blood is drained by gravity through two cannulae inserted into the superior and inferior vena cavae during bypass if the
circuitry and priming the cardio pulmonary bypass circuit consists of oxygenator tubings cannulae cardiotomy reservoirs and cardioplegia attachments
heparinisation the patient should be fully heparinised before the start of cardio pulmonary bypass baseline activated clotting time is measured
heat exchangers this is an integral part of cardio pulmonary bypass and is designed to cool and warm the perfusate non-sterile water from ice
membrane oxygenators they are more physiological and are similar to natural lungs there is separation of blood and gas by membrane across which gas
bubble oxygenators these have a mixing chamber where venous blood is collected and from the bottom end micro bubbles of oxygen are passed and as they
types of oxygenatorsa film oxygenatorsb disc oxygenatorsc bubble oxygenatorsd membrane oxygenatorsfilm and disc oxygenators are not used for clinical
ideal characteristics1 maximize gas transfer oxygen carbon dioxide and anaesthetic gases2 minimize blood trauma3 good heat transfer efficiency4
oxygenator they serve the function of lungs during extra corporeal circulation ecc - oxygenation removal of carbon dioxide and transport of
pulsatile perfusion conventional pumps give continuous flow with very little pulsatile property pulsatile perfusion is likely to result in better