Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension.

Introduction: Pulmonary thromboendarterectomy (PTE) is a surgical procedure which is considered the only effective and potentially curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). CTEPH is a rare outcome from pulmonary emboli and, when left untreated, will result in right ventricular failure and death.

Methods: From June 1999 to November 2003, 40 of these procedures were performed in our institution.

Plasma leakage of oxygenators in ECMO depends on the type of oxygenator and on patient variables.

This study was conducted to identify the causes of plasma leakage of oxygenators in extra corporeal membrane oxygenation (ECMO). From 1996 through 2002, 91 oxygenators were used in 62 patients undergoing ECMO for respiratory and/or cardiac failure. Several types of oxygenators were used (Medtronic Maxima, Minima, PRF, Medos Hilite).

The role of leukocyte depletion in ex vivo evaluation of pulmonary grafts from (non-)heart-beating donors.

If lungs could be retrieved for transplantation after circulatory arrest, the shortage of donors might be significantly alleviated. An important issue in using lungs from these so-called non-heart-beating donors is the development of a technique to assess their quality prior to transplantation without jeopardizing the life of the recipient. In our laboratory we tested the reliability of an ex vivo model for such an evaluation.

Impella: a miniaturized cardiac support system in an era of minimal invasive cardiac surgery.

In modern coronary bypass surgery, new objectives have been set based upon a minimal invasive approach: beating heart surgery is the new trend to follow, although this might not be feasible in more complex cases. In these cases, the beating heart could be supported by a mechanical device, preferably a device with minimal invasive features to fit in this new approach. For this purpose, two intravascular blood pumps were developed: the Intracardiac Pump LV for left ventricular support and the Intracardiac pump RV for right ventricular support.

A new pneumatic pump for extracorporeal circulation: TPP (true pulsatile pump). Experimental and first clinical results.

A pulsatile, membrane type pump, TPP, was developed for use in routine cardiac surgery. The artificial ventricle consists of a polycarbonate housing with an inlet and outlet polyurethane tricuspid valve. The membrane is actuated hydraulically.

The use of a heparin removal device: a valid alternative to protamine.

Purpose: Experiments were carried out to test the efficacy and safety of the heparin removal device, a plasmapheresis filter that binds and eliminates heparin, in the context of extracorporeal circulation.

Procedures And Findings: Six dogs were put on cardiopulmonary bypass after heparinization. Upon weaning, additional heparin was administered to obtain an activated clotting time above 900s.