Concordant Right and Left Heart Pressure and Flow Velocity Alternans

A technique was developed for closed-chest bypass of the right ventricle. Blood is removed from the right atrium and returned into the pulmonary artery. The blood return cannula can be inserted without x-ray equipment. The maximum flow through the system is ten liters per minute. Acute right ventricular failure produced by embolization of pulmonary arteries with starch could be treated promptly and repeatedly with the bypass. In six out of eight failure periods, the right ventricle had recovered after only five minutes of bypass. Progressive decrease of the arterial oxygen saturation, inherent with diffuse pulmonary embolization, could not be reversed. During ventricular fibrillation, while the circulation was maintained with closed-chest left ventricular bypass (transarterial), right heart bypass could not substitute right heart function. The reasons for this failure were incompetence of the pulmonary artery and tricuspid valves and increase of pulmonary arterial resistance.