Three clinical methods of circulatory assistance.

Three clinical methods of circulatory assistance are described: intraaortic balloon counterpulsation, left ventricular bypass using a roller pump, and the artificial ventricle. All three methods have hemodynamic effectiveness. The first method is indicated in cases of widespread cardiosclerosis and pronounced coronary insufficiency and may be contraindicated in pathology of the valvular apparatus. The second method demonstrated a temporary positive effect in patients in whom it was not possible to discontinue artificial circulation. The artificial ventricle is useful in treating patients with cardiogenic shock following cardiac surgery.

[Experimental study of the output characteristics of the left heart ventricle]. / eksperimental'noe opredelenie vykhodnykh kharakteristik levogo zheludochka serdtsa.

A method is suggested of evaluating the cardiac internal hydraulic resistance R0 and maximal blood flow at zero post load Q0. R0 in intact dogs is 11.9 mm/Hg/l/min and Q0 is 27.1 l/min. In the condition of acute cardiac insufficiency and under the effect of large adrenaline doses these parameters were, respectively, 8.8 mm Hg/l/min, 7.0 mm Hg/l/min and 36.9 l/min, 38.8 l/min. The reducing of of R0 reflect the reduction of rigidity of the myocardial wall, and the increase of Q0 reflects the increase of the cardiac muscle inotropism connected with the compensatory increase of the catecholamines level in blood.

[Cardiosynchronized perfusion of the coronary sinus as a method of myocardial revascularization]. / O kardiosinkhronizirovannoi perfuzii venechnogo sinusa kak metode revaskuliarizatsii miokarda.

The possibility of revascularization of the myocardium in acute ischemia by means of cardiosynchronized retrograde perfusion of the coronary sinus with arterial blood was studied. Signs of a decrease of the ischemic zone and improvement in the metabolism of the intact myocardium were noted.

[Trauma to the blood during assisted circulation]. / Travma krovi pri vspomogatel'nom krovoobrashchenii.

Trauma inflicted to blood in different method of assisted circulation was studied in experiments and in the clinic. Morphological disturbances of red blood cells and changes in their aggregation properties were revealed. Left ventricular shunt and aorto-aortic counter-pulsation are attended with increased aggregation properties of blood platelets. Aorta-aortic counter-pulsation causes a greater damaging effect than shunting of the left ventricle. Counter-pulsation by means of a balloon pump is attended with least hemolysis.

[Working organs of actuating devices for assisted circulation]. / Rabochie organy ispolnitel'nykh ustroistv dlia vspomogatel'nogo krovoobrashcheniia.

Business ends of operating mechanisms for assisted circulation, based on the principle of contrapulsation, must satisfy a number of requirements on which the safety and the effectiveness of their performance depend. Among these of particular importance are the working volume of the arrangement, correct conformity of the balloon and aorta diameters and also the duty cycle of the arrangement.

[Certain technical aspects of assisted circulation]. / Nekotorye tekhnicheskie aspekty vspomogatel'nogo krovoobrashcheniia

The paper treats of issues concerned with the control, designing of the drive and operating mechanisms of the equipment for assisted circulation, working on the principle of an oriented presure change in the cardio-vascular system. Problems relating to the cardiosynchronization of the therapeutic action, constructing a drive based on the use of a linear direct current motor and to the demands placed on the actuating mechanisms are discussed.