49 research outputs found

    Right ventricular function evaluated by volumetric analysis during left heart bypass in a canine model of postischemic cardiac dysfunction

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    AbstractRight ventricular function during left heart bypass was evaluated by volumetric analysis with a conductance catheter in 12 dogs with postischemic cardiac dysfunction. The conductance catheter was used to assess the volumetric status of the right ventricle and thereby allowed a right ventricular pressure-volume curve to be obtained, in which transient volume loading on the right ventricle was applied. The following right ventricular properties during left heart bypass were assessed and compared with properties measured without left heart bypass, by means of load-independent parameters: maximum elastance, stroke work/end-diastolic volume relation, end-diastolic pressure/volume relation, and stroke work/end-diastolic pressure relation. The stroke volume derived from the conductance catheter and the electromagnetic flow probe showed good linear correlation (r2 = 0.733 to 0.975). After initiation of left heart bypass, maximum elastance did not change significantly, although volume intercept significantly increased, from 1.2 ± 7.3 to 3.6 ± 7.9 ml ( p < 0.05). End-diastolic pressure/volume relation was well fitted to the exponential curve (EDP = e (k1 · EDV+k2) ) and was shifted to the right and downward during left heart bypass; the slope k1 significantly decreased, from 0.12 ± 0.06 to 0.10 ± 0.07 ( p < 0.01). Stroke work/end-diastolic volume relation and stroke work/end-diastolic pressure relation were closely fitted to the linear regression, and their slopes were significantly increased during left heart bypass, from 0.14 ± 0.08 to 0.18 ± 0.08 ( p < 0.05) and from 0.22 ± 0.15 to 0.34 ± 0.19 ( p < 0.01), respectively. These results suggest that the decompression of the left ventricle and septal shifting by left heart bypass provide good diastolic compliance and good systolic performance because of afterload unloading of the right ventricle. Thus the left heart bypass improved the overall right ventricular performance, particularly at higher end-diastolic pressures, in dogs with postischemic cardiac dysfunction. (J THORAC CARDIOVASC SURG 1995;109:796-803

    Autosynchronized systolic unloading during left ventricular assist with a centrifugal pump

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    AbstractObjectives: The purpose of this study was to investigate how the inflow cannulation site of the left ventricular assist system with a centrifugal pump would influence cardiac function on failing heart models. Methods: In 10 sheep, a left ventricular assist system was instituted by an outflow cannula in the descending aorta, two inflow cannulas in the left atrium and the left ventricle, and connecting those cannulas to a magnetically suspended centrifugal pump. A conductance catheter and a tipped micromanometer for monitoring the pressure-volume loop were also inserted into the left ventricle. Myocardial oxygen consumption was directly measured. Heart failure was induced by injection of microspheres into the left main coronary artery. The assist rate was varied from 0% to 100% at each inflow cannulation site. Results: The pump flow with left ventricular cannulation increased during the systolic phase and decreased during the diastolic phase, whereas it was constant with left atrial cannulation. Ejection fraction with left atrial cannulation decreased as the assist rate increased, whereas that with left ventricular cannulation was maintained up to 75% assist. The external work with left atrial cannulation decreased gradually as the assist rate increased, whereas the external work with left ventricular cannulation did not decrease until the assist rate reached 75%. The myocardial oxygen consumption in both cannulations decreased proportionally as the assist rate increased; they were significantly less with left ventricular cannulation at the 100% assist rate than with left atrial cannulation. Conclusion: Left ventricular cannulation during left ventricular assistance maintains ejection fraction and effectively reduces oxygen consumption.J Thorac Cardiovasc Surg 2003;125:353-6

    Recent Results from LHD Experiment with Emphasis on Relation to Theory from Experimentalist’s View

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    he Large Helical Device (LHD) has been extending an operational regime of net-current free plasmas towardsthe fusion relevant condition with taking advantage of a net current-free heliotron concept and employing a superconducting coil system. Heating capability has exceeded 10 MW and the central ion and electron temperatureshave reached 7 and 10 keV, respectively. The maximum value of β and pulse length have been extended to 3.2% and 150 s, respectively. Many encouraging physical findings have been obtained. Topics from recent experiments, which should be emphasized from the aspect of theoretical approaches, are reviewed. Those are (1) Prominent features in the inward shifted configuration, i.e., mitigation of an ideal interchange mode in the configuration with magnetic hill, and confinement improvement due to suppression of both anomalous and neoclassical transport, (2) Demonstration ofbifurcation of radial electric field and associated formation of an internal transport barrier, and (3) Dynamics of magnetic islands and clarification of the role of separatrix

    Extension of the operational regime of the LHD towards a deuterium experiment

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    As the finalization of a hydrogen experiment towards the deuterium phase, the exploration of the best performance of hydrogen plasma was intensively performed in the large helical device. High ion and electron temperatures, Ti and Te, of more than 6 keV were simultaneously achieved by superimposing high-power electron cyclotron resonance heating onneutral beam injection (NBI) heated plasma. Although flattening of the ion temperature profile in the core region was observed during the discharges, one could avoid degradation by increasing the electron density. Another key parameter to present plasma performance is an averaged beta value β\left\langle \beta \right\rangle . The high β\left\langle \beta \right\rangle regime around 4% was extended to an order of magnitude lower than the earlier collisional regime. Impurity behaviour in hydrogen discharges with NBI heating was also classified with a wide range of edge plasma parameters. The existence of a no impurity accumulation regime, where the high performance plasma is maintained with high power heating  >10 MW, was identified. Wide parameter scan experiments suggest that the toroidal rotation and the turbulence are the candidates for expelling impurities from the core region

    補助人工心臓の初期臨床応用

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