Document Detail


Pediatric cardiopulmonary bypass adaptations for long-term survival of baboons undergoing pulmonary artery replacement.
MedLine Citation:
PMID:  21114226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiopulmonary bypass (CPB) protocols of the baboon (Papio cynocephalus anubis) are limited to obtaining experimental data without concern for long-term survival. In the evaluation of pulmonary artery tissue engineered heart valves (TEHVs), pediatric CPB methods are adapted to accommodate the animals' unique physiology enabling survival up to 6 months until elective sacrifice. Aortic access was by a 14F arterial cannula and atrial access by a single 24F venous cannula.The CPB circuit includes a 3.3 L/min flow rated oxygenator, 1/4" x %" arterial-venous loop, 3/8" raceway, and bubble trap. The prime contains 700 mL Plasma-Lyte, 700 units heparin, 5 mL of 50% dextrose, and 20 mg amiodarone. Heparinization (200 u/kg) targets an activated clotting time of 350 seconds. Normothermic CPB was initiated at a 2.5 L/m2/min cardiac index with a mean arterial pressure of 55-80 mmHg. Weaning was monitored with transesophageal echocardiogram. Post-CPB circuit blood was re-infused. Chest tubes were removed with cessation of bleeding. Extubation was performed upon spontaneous breathing. The animals were conscious and upright 3 hours post-CPB. Bioprosthetic valves or TEHVs were implanted as pulmonary replacements in 20 baboons: weight = 27.5 +/- 5.6 kg, height = 73 +/- 7 cm, body surface area = 0.77 m2 +/- 0.08, mean blood flow = 1.973 +/- .254 L/min, core temperature = 37.1 +/- .1 degree C, and CPB time = 60 +/- 40 minutes. No acidosis accompanied CPB. Sixteen animals survived, four expired. Three died of right ventricular failure and one of an anaphylactoid reaction. Surviving animals had normally functioning replacement valves and ventricles. Baboon CPB requires modifications to include high systemic blood pressure for adequate perfusion into small coronary arteries, careful CPB weaning to prevent ventricular distention, and drug and fluid interventions to abate variable venous return related to a muscularized spleno-splanchnic venous capacity.
Authors:
Carrie Whittaker; Gary Grist; Arthur Bert; Kathleen Brasky; Stacy Neighbors; Christopher McFall; Stephen L Hilbert; William B Drake; Michael Cromwell; Barbara Mueller; Gary K Lofland; Richard A Hopkins
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Journal of extra-corporeal technology     Volume:  42     ISSN:  0022-1058     ISO Abbreviation:  J Extra Corpor Technol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2010-12-16     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0267637     Medline TA:  J Extra Corpor Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  223-31     Citation Subset:  T    
Affiliation:
Cardiac Surgery Research Laboratories, The Ward Family Center for Congenital Heart Disease, The Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Vessel Prosthesis Implantation*
Cardiopulmonary Bypass / methods*,  mortality
Heart Valve Prosthesis Implantation*
Male
Models, Animal
Papio
Pulmonary Artery / surgery*
Pulmonary Valve / surgery*
Survival Rate
Tissue Engineering
Grant Support
ID/Acronym/Agency:
P51 RR013986-11/RR/NCRR NIH HHS; P51RR013986-11/RR/NCRR NIH HHS
Comments/Corrections

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