A study about total pulmonary replacement with artificial intra-thoracic implantable lung.

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At present, RVAD is commonly used for a right ventricular failure (RVF). In clinic, RVF patients usually suffer poor gas exchange due to cardiac failure. The purpose of this study is whether pumpless ECMO in right ventricle (RV) to left atrium (LA) bypass could be useful as a means of a treatment for a chronic RVF. Experiment I. Ten mongrel dogs (2.5-6.0 kg, mean 3.9kg) were performed banding of the main pulmonary artery (mPA), aimed for RVF due to pulmonary hypertension. A pressure study of the right heart was performed after a long term raising (97-205 days, mean 160 days). All the cases showed the mean RV pressure (m-RVP)[mmHg]【greater than or equal】20 (average 30. 2±9.0 mmHg).Experiment II. Implantation of the artificial lung (MENOX EL2000, Kuraray Co. Japan) was perfomed between RV outlet and LA for ten of the RVF model. As we lost one animal during operation, nine (4.8-8.4kg, mean 6.5kg) were used to evaluate the gas transfer and the cardiac function. All the cases showed the m-RVP (average 20.7±4.2 mmHg) after the RV-LA bypass was equal to the preoperative value or dropped, and the average cardiac function tended to be improved. Experiment III. After experiment II, the nine dogs were performed ligation of mPA and total RV-LA bypass was started. Five (4.8-8.4kg, mean 6.6kg) of nine RVF model were supported over 6 hours and evaluated the gas transfer and cardiac function (group I), while the other four died soon after ligation of mPA due to RVF. Five non-PA banding mongrels with the memnbrane oxygenator were used as control (Group II). Group I, aswell as Group II, showed good gas transfer rates, averages of 32.5 ± 8.3ml/min. of 02 and 37.2±11.6ml/min. of C02 with a blood flow rate of 0.68±0.19 L/min.A partial bypass between RV-LA with the commercially available membrane oxygenator provides better recovary of RVF than a total bypass in RVF model.