CARDIAC BYPASS:APPLICATION OF A MECHANICAL HEART AND LUNG APPARATUS
+Post-Doctoral Fellow Department.of Electrical Engineering Indian Institute ofTechnology New Delhi 110016 India,
*Cardio Thoracic Surg.,Department of Cardio Thoracic Surgery St Stephen'sHospital Tis Hazari Delhi
++Director Helmholtz Institut Fur BioMedinische Universitat Aachen Germany
offsprings can have it.Impure blood duringcirculation affects the lungs,left artery to
right ventricle.Arterial defect ,a hole inthe heart,blood takes short track instead of
This paper deals with the problem of bypass
proper channel,it escapes, oxygenated blood
surgery.lt examines the basic mechanical and
mixes with deoxygenated one.Defects occur in
physiological problems of the heart and lung.
The paper assumes that the cardio-pulmonary
operation.Ventricular septic defect.blood
bypass is a technique by which the pumping
forcing into the aorta is diverted,lung gets
more blood. Several factors postulating this
functions of the lung are temporarily replac-
ed by a mechanical device,the pump oxygenat-
India.Blue baby is obstruction to one of the
or attached to the vascular system of the
arteries.The baby can not strive cries, and
patient.Studies have been carried out on over
is called Tetralogy of Fallot.Blood vessels
250 patients on open heart operations and
are wrongly connected and oxygenated blood
clinical perfusion of cardiopulmonary bypass.
The contributions of this paper is based on
the results obtained from successful patients
abnormal progress.Endocardigraphic machine
operations models of preoperative and post
detects if a child has disease.Diagnosis is
operative procedures.The paper revealed that
by surgery.For closed heart does not involve
patients with angina pectoris senosis complic-
ations in heart attack and young individuals
with heart diseases need CPB.The result ind-
sophisticated equipments.The cost is 1 lakh
icates that the CPB is relatively safe in the
including entire period of treatment.Funding
sense that many patients got releif who suffe-
organisation and Government deffer the cost
red from the intracardiac and excruciating
of importing disposable valves.Trivandrum
pain.The new trend is that the study identi-
is one centre.Valvular disease isdone.Chinese
fies bypass surgery as one of the greatest
valves are less costly.Reheumatic fever is in
contributions,grouped in line with the disc
India,and gives sour throat caused by bacter-
overy of antib iotics and insolin with regards
ia, reaction in body manifestation.Mitral
valve is one way passage ,block the lungs
useful in the sense that it has prevented
easily tackled by method of ballon either to
many early deaths and has helped innumerable
repair or replace them by artificial heart
patients to live normal lives.The limitation
is that only certain persons can benefit from
this procedure.Computer Subroutine Models and
performed.:Mitral valve artery and cardiac
heart stop noted at 30 units to 217 minutes
aortic clamped.Valve variable was 0,6repaired to 3.5 cm .
bypass surgery. Valve was opened and closed,
operations and clinical perfusion for cardiac
the mitral valve repairesd.In another case,
pulmonary bypass problems.Cardio-pulmonary
bypass involves a technique or methodological
valve) 0.6 opened to 3.5 using Tubbb.Mitral
procedures by which the pumping action of the
valve was leaking and narrowed. Mr Mathews MP
heart,and the gas exchange functions of the
aged 63years had mitral valve grafting.lt
lung are replaced temporarily by the pump-
took 9am - 3pm coronary artery block bypass
oxygenator,connected to the vascular system
surgery.ECG was 80 per minute,BP 80-144 and
of the patient.CPB is a safe clinical tool
at the intensive care the X ray was taken at
for~~risk patients having coronary artery
bypass, grafting can be done with a hospital
Aortic Cardio Pulmonary Bypass was a case
mortality of less than l%.In seriously ill
of aneurysm of abdominal aorta resection and
patients,very young or old CPB contributes to
grafting using Dador graft gelsad.Other oper-
morbility and mortality.Damaging effect of
ations that took place include myocarditis-
myocardium,anginapectoris-occurrence of pain-chest, pericarditis-inflammation of the
enveloping membrane of the heart-bacterial
categorization.lt is rampant among the rich
infection-rheumatic fev«>r and conginital
typically of the west.Defect occur at upper
children.Parents with defective genes,their (i) 0.2% dex with 90mg vite according to
Proceedings RC-IEEE-EMBS & 14th BMESI -1995 PS15
Glucose 10/dex add Inj with Insoline 10 unit
30ml/hr, Inj K.CL lgm (iii) 5% with Injection
Doparine 400mg/500 ml.according to patientBP.(iv)NTC Nitrobyceine 25mg/500 ml or
50mg/500 ml.(v) Blood transfusion acceding
to HB report 3 or 4 point (of surg).Total 15days in the hospital is allowed.CABG andValue replacement:Sug Pest of orders and
(vi)injection Omnatax 1 gm 6 hrly(vii) Irij.
Coulta 60mg 8hrly (viii)Inject Morphine 3mgSOS If chest drainage is more than 100 Ml/hr,then we give Injection. Protamine 1 amp.v
stat or 2 mg sat,If urinary output is low 60
ml/hr or 25 ml/hr then Inj.lasix to be given. We will keep the pH to CTS ICU atleast 1 week
after that we will transfer the Patient toCTS ward (General ward or put in the ward. Figure 1 illustrates details observed in the
intensive care.Enough concentrated serium
albium is added to the balanced salt solution
infants.Glucose concentration 350 mg per centis delibrately raised to promote osmoticdirenis during and for a few hours afteroperation and to provide energy source.
Name of patient Sirequiddin AorticR on 1.46pm
Height 170 cm 3.4m/Operation AVR Aortic off 2.31pmAnaest 11.00 am Card P 1.59pm/900mgOD st 11.5am Urine at lOOmg
Bypass on 1.45pm urine 600mm,- 500Bypass off 2.31 pm Heparine tr 1.34 pm/180mgurine dur 250mm-100 urine off 100mm Temp 38*C
In view of the subjectivity of this study,
according to Paul CNjoku and Prof G.Rau Direc-tor of HIBMEDE Universitat Technik Aachen in
scope of extension by way of a wide range ofsimulations in the form of Sensitivity Study. This refers to inclusion of autonomous controlof implantable electromechanical artificial
heart to analyse the reciprocal effects ofhuman physiology respectively pathology andTAH technology.Systems analysis specificallymotor control and sensors,stability and sensitivity evaluation are proposed.The results ofthese studies serve as a base for the designof an experimental extracorporeal control andmonitoring unit in the context of total artificial heart.They will also serve the futuredevelopment of an intracorporeal miniaturisedcontrol unit [ . J .
Safe CPB is characterized by the absence ofstructural or functional damage after the
perfusion.This is complete due to profound
hypothermia.Thousands of patient have noapparent ill effects from CPB.Coroary Artery
DeseasefCAD),CABG,and increasing number of
patients are subjected to observation.
[l]Paul.CNjoku(1994)Experience of over 250
Research and Development in cardiac assist
openheart operations and clinical perfusion
devices under Biomechanic Design is vital.
for cardiopulmonary bypass RAThesis underDr
[2.]Paul.CN Autonomous Control of Implantable
The auspicious opportunity to trainDrPaul was
Electromechanical ArtifificialHeartHelmholtz
TAH BioMechanic Cardiac Assist Devices PD
Thesis under UnivProfDrG.Rau Dir HIBM Aachen
ging the reverential admirations tothem ismvpleasant and dutiful awe.lam grateful to nrBrown,ProfSAnand and ProfDrGuha for support.
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