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November 1966

Single Heat Exchanger: Use for Controlled Myocardial and Generalized Hypothermia

Author Affiliations

From the Department of Surgery, Wayne County General Hospital, Eloise.

Arch Surg. 1966;93(5):838. doi:10.1001/archsurg.1966.01330050142022

THE CLINICAL use of generalized hypothermia in cardiopulmonary by-pass described by Sealy and associates has proved to be a valuable modality.1 The decrease in metabolic requirements contributes to a safer by-pass. Controlled myocardial hypothermia in conjunction with systemic hypothermia may be desirable during aortic valvular operations. This is usually accomplished with two heat exchangers; one in the systemic arterial circuit and another in the coronary perfusion circuit. An alternative method using a single heat exchanger eliminates unnecessary equipment and preparation.

Method  The circuit required for controlled myocardial and generalized hypothermia with one heat exchanger is diagrammed in the Figure. A line detouring the heat exchanger is placed so that oxygenated blood may either flow completely through the heat exchanger or may be partially detoured from the heat exchanger. Blood for coronary perfusion is taken from the systemic arterial line distal to the heat exchanger but proximal to the detour

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