Beneficial effects of pulsatile perfusion in the hypertrophied ventricle during ventricular fibrillation

T. J. Bixler, P. G. Magee, J. T. Flaherty, T. J. Gardner, Vincent L Gott

Research output: Contribution to journalArticle

Abstract

To assess the potential benefit of pulsatile perfusion in the hypertrophied heart during fibrillation, 10 dogs with left ventricular hypertrophy, produced by previous supravalvular aortic banding, were used to compare linear and pulsatile perfusion in the fibrillating heart during total cardiopulmonary bypass. The mass spectrometer was used to measure subendocardial Pco 2 and Po 2 (Pmco 2 and Pmo 2), and radioactive microspheres were utilized to measure myocardial blood flow in the same layers. Pulsatile perfusion was established using the recently developed 'bubble tubing', which produces a pulse pressure of at least 20 mm Hg and can be use in a standard roller-pump apparatus. Both linear and pulsatile flows were compared at mean aortic root pressures of 80 and 50 mm Hg, and these four combinations of aortic root pressure and type of flow were employed for periods of 30 minutes each. Myocardial ischemia developed during linear coronary perfusion at 50 mm Hg, as evidenced by an elevation of Pmco 2. Ischemia was not evident during pulsatile perfusion at the same mean pressure. Reversal of ischemia was a result of increased myocardial blood flow and pulsatile perfusion, and this increase was shown to occur maximally in the deeper subendocardial layer. Ischemia was not evident during linear or pulsatile perfusion at an mean perfusion pressure of 80 mm Hg. Thus, if lower perfusion pressures are to be tolerated in patients with left ventricular hypertrophy, pulsatile perfusion with the bubble tubing technique may prevent the development of subendocardial ischemia or infarction.

Original languageEnglish (US)
JournalCirculation
Volume60
Issue number2 II
Publication statusPublished - 1979
Externally publishedYes

    Fingerprint

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this