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D Arzouman

Publications and source records attributed to D Arzouman.

2 recordsLinked to original sources

Comparison of Sarns 3M heparin bonded to Duraflo II and control circuits in a porcine model: macro- and microanalysis of thrombi accumulation in circuit arterial filters.

Heparin-bonded perfusion circuits have been reported to reduce the thrombus formation during various levels of systemic heparinization. The goal of this study was to compare the efficacy of thrombo-resistance of the Sarns 3M heparin-bonded circuit to Baxter Duraflo II and untreated control in a porcine model. Fifteen Yorkshire pigs (60-65 kg) were anesthetized, heparinized with 3000 IU, intravenously (i.v.) and surgically cannulated with an internal jugular outflow and a femoral vein inflow. All circuits consisted of a 22-Fr venous cannula, centrifugal pump, arterial filter, an 18-Fr cannula for return and connected with equal lengths of 3/8" polyvinyl chloride tubing. The flows were maintained at 2.0 l/min for 4 h. Thrombus formation in filter samples were morphometrically analyzed through macro-densitometry, light microscopy, and scanning electron microscopy (SEM). Our findings revealed that the 3M circuit had significantly less gross thrombus (p < 0.001), 66% and 84% less microscopic thrombi and fivefold less SEM-measured aggregates (p = 0.03) compared to the Duraflo II and uncoated groups. This study demonstrated that the 3M heparin-bonded circuit had significantly reduced the formation of micro- and macro-thrombi in the minimally heparinized pig model compared to the Duraflo II and untreated control circuits.

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Ventriculoarterial coupling influences regional contractility.

The purpose of this study was to adjudicate whether concomitant manipulation of inotropic state and arterial elastance influences linear indices of regional contractility. Fifteen autonomically denervated open-chest porcine hearts were instrumented with midmyocardial ultrasonic crystals and aortic and left ventricular chamber microamanometers. Linear left anterior descending coronary artery regional stroke work vs preload relationships (RSW) were generated by 10-sec vena caval occlusion at control and altered contractile states (either dopamine, 5 micrograms/kg/min, or propranolol, 0.2 mg/kg) and following arterial elastance variation (phenylephrine or nitroprusside), effecting an average 30% change in mean arterial pressure (MAP). Global contractility (dP/dt) was doubled (227% of control) by dopamine and halved (35% of control) by propranolol at constant preload (end-diastolic volume, end-diastolic pressure) and afterload (MAP). Regional contractility (RSW slope) was increased from 135 +/- 11 to 211 +/- 28, P less than 0.01, by dopamine, but unchanged with propranolol (106 +/- 10 vs 118 +/- 14, NS). Bidirectional changes in aortic elastance depressed the dopamine-augmented RSW slope (115 +/- 17, nitroprusside; 132 +/- 14, phenylephrine; P less than 0.01 vs dopamine). These differences were attenuated by propranolol infusion (98 +/- 7, nitroprusside; 132 +/- 9, phenylephrine; NS vs propranolol). Thus, optimizing ventriculoarterial coupling should supersede simple afterload manipulation in perioperative cardiac support.

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