CLINICAL AND HEMATOLOGICAL EVALUATION OF THE ANTITHROMBOTIC CARDIOPULMONARY BYPASS FOR THE OPERATIONS OF THE THORACIC DESCENDING AORTIC ANEURYSMS
Consecutive 8 patients involving true or dissecting aneurysms of the thoracic descending aorta or thoracoabdominal aorta were operated upon under the partial cardiopulmonary bypass using the antithrombotic coated device. The system is consisted of Maxima membrane oxygenator, Bio-Medicus centrifugal...
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| Published in | Jinko Zoki Vol. 24; no. 2; pp. 507 - 512 |
|---|---|
| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
JAPANESE SOCIETY FOR ARTIFICIAL ORGANS
1995
一般社団法人 日本人工臓器学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0300-0818 1883-6097 |
| DOI | 10.11392/jsao1972.24.507 |
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| Abstract | Consecutive 8 patients involving true or dissecting aneurysms of the thoracic descending aorta or thoracoabdominal aorta were operated upon under the partial cardiopulmonary bypass using the antithrombotic coated device. The system is consisted of Maxima membrane oxygenator, Bio-Medicus centrifugal pump, and Medtronic percutaneous thin wall cannulae. These were all coated with Carmeda Bioactive Surace. Polyvinyl tube was coated with Biomate. The administration of systemic heparin was determined by ACT of around 200 seconds. All patients were tolerated operations well and alive. No thromboembolic accident, bleeding tendency, nor organ failure including renal failure were observed postoperatively in all patients. The analysis of blood platelets, coagulation, and fibrinolysis system revealed minimal fluctuation of the values. In conclusion, this system of anti thrombotic circuit is safe and preferable for thoracic descending or thoraco-abdominal aneurysm operations. |
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| AbstractList | Consecutive 8 patients involving true or dissecting aneurysms of the thoracic descending aorta or thoracoabdominal aorta were operated upon under the partial cardiopulmonary bypass using the antithrombotic coated device. The system is consisted of Maxima membrane oxygenator, Bio-Medicus centrifugal pump, and Medtronic percutaneous thin wall cannulae. These were all coated with Carmeda Bioactive Surace. Polyvinyl tube was coated with Biomate. The administration of systemic heparin was determined by ACT of around 200 seconds. All patients were tolerated operations well and alive. No thromboembolic accident, bleeding tendency, nor organ failure including renal failure were observed postoperatively in all patients. The analysis of blood platelets, coagulation, and fibrinolysis system revealed minimal fluctuation of the values. In conclusion, this system of anti thrombotic circuit is safe and preferable for thoracic descending or thoraco-abdominal aneurysm operations. Consecutive 8 patients involving true or dissecting aneurysms of the thoracic descending aorta or thoracoabdominal aorta were operated upon under the partial cardiopulmonary bypass using the antithrombotic coated device. The system is consisted of Maxima membrane oxygenator, Bio-Medicus centrifugal pump, and Medtronic percutaneous thin wall cannulae. These were all coated with Carmeda Bioactive Surace. Polyvinyl tube was coated with Biomate. The administration of systemic heparin was determined by ACT of around 200 seconds. All patients were tolerated operations well and alive. No thromboembolic accident, bleeding tendency, nor organ failure including renal failure were observed postoperatively in all patients. The analysis of blood platelets, coagulation, and fibrinolysis system revealed minimal fluctuation of the values. In conclusion, this system of anti thrombotic circuit is safe and preferable for thoracic descending or thoraco-abdominal aneurysm operations. 8例の真性胸部下行大動脈瘤、及びDeBakeyIIIb型解離性大動脈瘤(胸腹部大動脈瘤を含む)に対し、部分体外循環法による手術を行った。部分体外循環法として、ヘパリンコーティングを付した遠心ポンプ、膜型肺、大腿動静脈経皮的カニューラを用い、またチューブ内コーティングとしてBiomateを用いた抗血栓性材料による閉鎖回路とした。全身投与ヘパリンとしてActivated coagulation time (ACT)を200秒に維持した。全例軽快退院した。本補助循環法に起因すると考えられる血栓塞栓症や、術後臓器不全合併、肺出血も認めなかった。血中血小板、凝固線溶系の検索においても、その変動は軽微であり24時間後にはほぼ術前値に復帰していた。以上より、抗血栓性を付加した本法は、臨床的に従来より指摘されてきた部分体外循環法における術後出血傾向を防ぎうる点で有用なシステムであると考えられた。 |
| Author | ARIMURA, Y. KOKUBO, J. EGAMI, J. IKEDA, K. WATANABE, Y. HAYASHI, N. SUDO, K. SASAGAWA, S. HONDA, K. KOISHIZAWA, T. TONARI, K. IDE, H. FUJIKI, T. AIZAKI, M. |
| Author_FL | 井手 博文 相崎 雅弘 池田 晃冶 小石 沢正 本田 克彦 笹川 成 戸成 邦彦 藤木 達雄 江上 純 林 信成 有村 康夫 須藤 憲一 小久保 純 渡辺 寛 |
| Author_FL_xml | – sequence: 1 fullname: 井手 博文 – sequence: 2 fullname: 藤木 達雄 – sequence: 3 fullname: 小石 沢正 – sequence: 4 fullname: 渡辺 寛 – sequence: 5 fullname: 江上 純 – sequence: 6 fullname: 林 信成 – sequence: 7 fullname: 相崎 雅弘 – sequence: 8 fullname: 小久保 純 – sequence: 10 fullname: 戸成 邦彦 – sequence: 11 fullname: 笹川 成 – sequence: 12 fullname: 本田 克彦 – sequence: 13 fullname: 有村 康夫 – sequence: 14 fullname: 池田 晃冶 – sequence: 15 fullname: 須藤 憲一 |
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| References | 6) Connors JP, Ferguson TB, Roper CL, Weldon CS: The use of the TDMAC-heparin shunt in replacement of the descending thoracic aorta. Ann Surg 181: 735, 1975. 3) 川人宏次, 井野隆史, 安達秀雄, 井手博文, 水原章浩, 山口敦司, 村田聖一郎: 胸部大動脈瘤手術における新しい補助手段―少量のヘパリンで管理する抗血栓性部分体外循環法. 人工臓器 23: 102, 1994. 5) Crawford ES, Rubio PA: Reappraisal of adjuncts to avoid ischemia in the treatment of aneurysms of descending thoracic aorta. J Thorac Cardiovasc Surg 66: 693, 1973. 13) Aranki SF, Adams DH, Rizzo R, Couper GS, DeCamp MM, Fitzgerald DJ, Cohn LH: Femoral venoarterial extracorporeal life support with minimal or no heparin. Ann Thorac Surg 56: 149, 1993. 15) 堀越茂樹, 中野雅道, 橋本和宏, 江本秀斗, 小柳勝司, 金沢俊行, 黒沢博身: ヘパリン結合膜型人工肺使用開心術における凝固・線溶・補体系の変動について. 人工臓器 2: 895, 1993. 7) 茂泉善政,安部康之, 伊藤智宏, 清水雅行, 近藤俊一, 赤坂純逸, 鈴木一郎: 遠心ポンプを用いた胸部下行大動脈手術―大量出血時の対策としてのマルチパーパス回路の臨床使用経験―. 日胸外会誌 40; 2205, 1992. 11) 平山哲三, 山崎哲, 清水剛, 阿久津博美, 首藤裕, 小長井直樹, 長田一仁, 長江恒幸, 石丸新, 古川欽一: 胸部下行大動脈手術における補助手段としての遠心ポンプバイパス法の検討. 日胸外会誌 39: 1153, 1991. 9) Olivier HF, Maher TD, Liebler GA, Park SB, Burkholder JA, Magovern GJ: Use of the BioMedecus centrifugal pump in the traumatic tears of the thoracic aorta. Ann Thorac Surg 38: 586, 1984. 4) Larm O, Larsson R, Olssen P: A new non-thrombogenic surface prepared by selective covalent binding of heparin via a modified reducing terminal residue. Biomat Med Dev Art Org 11: 161, 1983. 12) von Segesser LK, Weiss BM, Garcia E, von Felton A, Turina MI: Reduction and elimination of systemic heparinization during cardiopulmonary bypass. J Thorac Cardiovasc Surg 103: 790, 1992. 10) Diehl JT, Payne DD, Rastegar H, Cleveland RJ: Arterial bypass of the descending thoracic aorta with the BioMedecus centrifual pump. Ann Thorac Surg 44: 422, 1987. 8) 土田弘毅, 橋本明政, 青見茂之, 清野隆吉, 小柳仁, 佐々木章, 風間茂, 鈴木進: 全身ヘパリン化をしない左心バイパス(Bio-pump)使用による胸部下行大動脈グラフト置換術の臨床経験. 人工臓器 17: 884, 1988. 2) Kazui T, Komatsu S, Yokoyama H: Surgical treatment of aneurysms of the thoracic aorta with the aid of partial cardiopulmonary bypass. An analysis of 95 patients. Ann Thorac Surg 43: 622, 1987. 14) 重光修, 葉玉哲生, 高橋英己, 森義顕, 木村龍範, 迫秀則, 添田徹, 内田雄三: 活性ヘパリンにて表面処理されたCarmeda MAXIMAの臨床的検討―従来型MAXIMA肺との比較検討. 人工臓器 2: 890, 1993. 1) Dillon ML, Young WG, Sealy WC: Aneurysms of the descending thoracic aorta. Ann Thorac Surg 3: 430, 1967. 16) Thelin SH, Hultman J, Borowiec J, Nilsson L, Thorelius J: Heparin-coated cardiopulmonary bypass circuits reduce blood cell trauma. Experiments in the pig. Eur J Cadiothorc Surg 5: 486, 1991. |
| References_xml | – reference: 3) 川人宏次, 井野隆史, 安達秀雄, 井手博文, 水原章浩, 山口敦司, 村田聖一郎: 胸部大動脈瘤手術における新しい補助手段―少量のヘパリンで管理する抗血栓性部分体外循環法. 人工臓器 23: 102, 1994. – reference: 14) 重光修, 葉玉哲生, 高橋英己, 森義顕, 木村龍範, 迫秀則, 添田徹, 内田雄三: 活性ヘパリンにて表面処理されたCarmeda MAXIMAの臨床的検討―従来型MAXIMA肺との比較検討. 人工臓器 2: 890, 1993. – reference: 10) Diehl JT, Payne DD, Rastegar H, Cleveland RJ: Arterial bypass of the descending thoracic aorta with the BioMedecus centrifual pump. Ann Thorac Surg 44: 422, 1987. – reference: 11) 平山哲三, 山崎哲, 清水剛, 阿久津博美, 首藤裕, 小長井直樹, 長田一仁, 長江恒幸, 石丸新, 古川欽一: 胸部下行大動脈手術における補助手段としての遠心ポンプバイパス法の検討. 日胸外会誌 39: 1153, 1991. – reference: 2) Kazui T, Komatsu S, Yokoyama H: Surgical treatment of aneurysms of the thoracic aorta with the aid of partial cardiopulmonary bypass. An analysis of 95 patients. Ann Thorac Surg 43: 622, 1987. – reference: 15) 堀越茂樹, 中野雅道, 橋本和宏, 江本秀斗, 小柳勝司, 金沢俊行, 黒沢博身: ヘパリン結合膜型人工肺使用開心術における凝固・線溶・補体系の変動について. 人工臓器 2: 895, 1993. – reference: 13) Aranki SF, Adams DH, Rizzo R, Couper GS, DeCamp MM, Fitzgerald DJ, Cohn LH: Femoral venoarterial extracorporeal life support with minimal or no heparin. Ann Thorac Surg 56: 149, 1993. – reference: 16) Thelin SH, Hultman J, Borowiec J, Nilsson L, Thorelius J: Heparin-coated cardiopulmonary bypass circuits reduce blood cell trauma. Experiments in the pig. Eur J Cadiothorc Surg 5: 486, 1991. – reference: 9) Olivier HF, Maher TD, Liebler GA, Park SB, Burkholder JA, Magovern GJ: Use of the BioMedecus centrifugal pump in the traumatic tears of the thoracic aorta. Ann Thorac Surg 38: 586, 1984. – reference: 7) 茂泉善政,安部康之, 伊藤智宏, 清水雅行, 近藤俊一, 赤坂純逸, 鈴木一郎: 遠心ポンプを用いた胸部下行大動脈手術―大量出血時の対策としてのマルチパーパス回路の臨床使用経験―. 日胸外会誌 40; 2205, 1992. – reference: 12) von Segesser LK, Weiss BM, Garcia E, von Felton A, Turina MI: Reduction and elimination of systemic heparinization during cardiopulmonary bypass. J Thorac Cardiovasc Surg 103: 790, 1992. – reference: 1) Dillon ML, Young WG, Sealy WC: Aneurysms of the descending thoracic aorta. Ann Thorac Surg 3: 430, 1967. – reference: 5) Crawford ES, Rubio PA: Reappraisal of adjuncts to avoid ischemia in the treatment of aneurysms of descending thoracic aorta. J Thorac Cardiovasc Surg 66: 693, 1973. – reference: 4) Larm O, Larsson R, Olssen P: A new non-thrombogenic surface prepared by selective covalent binding of heparin via a modified reducing terminal residue. Biomat Med Dev Art Org 11: 161, 1983. – reference: 6) Connors JP, Ferguson TB, Roper CL, Weldon CS: The use of the TDMAC-heparin shunt in replacement of the descending thoracic aorta. Ann Surg 181: 735, 1975. – reference: 8) 土田弘毅, 橋本明政, 青見茂之, 清野隆吉, 小柳仁, 佐々木章, 風間茂, 鈴木進: 全身ヘパリン化をしない左心バイパス(Bio-pump)使用による胸部下行大動脈グラフト置換術の臨床経験. 人工臓器 17: 884, 1988. |
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| SubjectTerms | antithrombotic circuit descending aortic aneurysm heparin coating partial cardiopulmonary bypass |
| Title | CLINICAL AND HEMATOLOGICAL EVALUATION OF THE ANTITHROMBOTIC CARDIOPULMONARY BYPASS FOR THE OPERATIONS OF THE THORACIC DESCENDING AORTIC ANEURYSMS |
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