HEART LUNG MACHINE

A medical equipment that provides

Cardiopulmonary bypass, (temporary mechanical
circulatory support) to the stationary heart and lungs)
Heart and Lungs are made "functionless
temporarily" , in order to perform surgeries
CABG
Valve repair
Aneurysm
Septal Defects

 The first known operation involving open

heart with temporary mechanical takeover
of both heart and lung functions on April 5,
1951 at the University of Minnesota
Hospital. The patient did not survive due to
an unexpected complex heart defect.
The first successful open heart procedure
on a human utilizing the heart lung
machine was performed on May 6, 1953 at
Thomas Jefferson University Hospital in
Philadelphia.

Components
Five pump assemblies (Pump headperistaltic pump)
Venous Cannula
Arterial Cannula - dual-stream aortic
perfusion catheter / meshed cannula
Venous Reservoir
Oxygenators
Heat Exchangers
Cardioplegia

 Five Pump heads

One for perfusion of the body, two
suckers and two for perfusion of the
coronary arteries
Main perfusion system- Pump head 1 and
combination of heat exchanger/oxygenator.
Heat exchanger consists of water coils and
a temperature controller that permits
pump oxygenator to keep the blood at a
proper temperature and compensate heat
loss through radiation from the lines

 Blood flows from superior and inferior

venae cavae to O2minus side.
Pump heads 2 vent blood from right
ventricle while pump head 3 is used
to suck blood during surgery.
From O2positive side blood is taken
by pumps 4 and 5 to perfuse
coronary arteries.

Centrifugal and Roller pump

Centrifugal pumps consist of plastic cones, which
when rotated rapidly, propel blood by centrifugal
force.
Forward blood flow, varies with the speed of
rotation and the after load of the arterial line.
Centrifugal blood pumps generate up to 900 mm
Hg of forward pressure, but only 400 to 500 mm
Hg of negative pressure. Hence, less gaseous
micro emboli.
Centrifugal pumps produce pulse less blood flow

 Roller pumps consist tubing, which is

compressed by two rollers 180
apart.
Forward flow is generated by roller
compression and flow rate depends
upon the diameter of the tubing, rate
of rotation.

 A- Roller pump
B- Impeller pump
C- Centrifugal pump

Cannula
A cannula (plural cannulae) or canula is a
tube that can be inserted into the body.
Multiple cannulae are sewn into the
patient's body in a variety of locations,
depending on the type of surgery.
A venous cannula removes oxygen
deprived blood from a patient's body.
An arterial cannula is sewn into a
patient's body and is used to infuse
oxygen-rich blood

Venous Reservoirs
Reservoirs may be rigid (hard) plastic
canisters ("open" types) or soft,
collapsible plastic bags ("closed" types).

The venous reservoir serves as

volume reservoir

Facilitates gravity drainage,

Venous bubble trap present,

Provides a convenient place to add

drugs, fluids, or blood, and adds storage
capacity for the perfusion system.

Heat Exchanger
Control body temperature by heating
or cooling blood passing through the
perfusion circuit
Temperature differences within the
body and perfusion circuit are limited
to 5C to 10C to prevent bubble
emboli

Cardioplegia
It is a separate circuit for infusing a
solution into the heart itself to
produce cardioplegia (i.e. to stop the
heart from beating), and to provide
myocardial protection (i.e. to prevent
death of heart tissue).

 Polyvinyl Chloride (PVC) tubing are used. It is

flexible, compatible with blood, inert, nontoxic,
smooth, nonwettable, tough, transparent,
resistant to kinking and collapse. I tis sterilized
by Duraflo II heparin coating.
In the circuit, micro emboli are monitored by
arterial line ultrasound or monitoring screen
filtration pressure. Depth filters consist of
porous foam, have a large, wetted surface and
remove micro emboli by impaction and
absorption. Screen filters are usually made of
woven polyester or nylon thread

Oxygenators

Membrane oxygenator
Imitate the natural lung by interspersing a
thin membrane of either micro porous
polypropylene or silicone rubber between
the gas and blood phases.

With micro porous membranes, plasmafilled pores prevent gas entering blood but
facilitate transfer of both oxygen and CO2.

The most popular design uses sheaves

of hollow fibers connected to inlet and
outlet manifolds within a hard-shell jacket.

Bubble oxygenator
Venous blood drains directly into a
chamber into which oxygen is infused
through a diffusion plate (sparger).

The sparger produces thousands of

small (approximately 36 m) oxygen
bubbles within blood.

Gas exchange occurs across a thin film

at the blood- gas interface around each
bubble

Produce more particulate and gaseous

microemboli are more reactive to blood
elements.

 bubble oxygenator a device in which pure oxygen is

bubbled through an extracorporeal reservoir of blood, either
directly or through a filter.
film oxygenator a device, encased in a container of
oxygen, that makes possible reduction of a thin film of blood
to facilitate the exchange of gases.
pump oxygenator heart-lung machine.
rotating disk oxygenator a type of film oxygenator in
which a series of parallel disks rotate through an
extracorporeal pool of venous blood in a container of oxygen;
gaseous exchange occurs between the thin film of blood on
the exposed surface of the disks and the oxygen in the
container.
screen oxygenator a type of film oxygenator in which the
venous blood is passed over a series of screens in a
container of oxygen, gaseous exchange taking place in the
thin film of blood produced on the screens.