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By A. Misra

ISBN-10: 9535103768

ISBN-13: 9789535103769

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1976)) (Abshire, 2009). This endothelial dysfunction syndrome is most probably occurred due to steady flow, foreign surfaces and the severe momentum energy losses. To overcome these side effects different therapeutic strategies are currently applied (Nour S, 2003), such as: a) pharmacological supports using antifibrinolytic (Cooper, 2006), inotropes, vasodilators, platelets, etc. 2°C (Box, et al. 2005). ,1999); (Undar, et al. 2006). , 2010). This may be explained by pulsatile CPB inadequate curves with the necessity of a double perfusion pumps system to compensate the oxygenators momentum energy losses.

5. Methods for shear stress-mediated endothelial function stimulations According to the present concept, the method consists in using at least one device external to the patient’s body and connected by at least a pipe and/or a specific connection element to: 1. 2. 3. Increase the preload of the right ventricle so as to improve myocardial oxygenation and so as to improve its contractility; and/or Unload the left ventricle and diffuse regular pulsatile flow in the proximity of the aortic root so as to improve the hemodynamics of the left ventricle of the heart; and/or Stimulate the endothelium mechanically by shear stress enhancement so as to release several mediators of endothelial vasodilators like nitric oxide (NO), to reduce the systemic and pulmonary vascular resistances (afterload).

Z2 Aorta + Valsalva High  Shear stress (Newton): peristaltic pump + gravity effect at the Valsalva;  Laplace (less restricted external sheath at the arch),  resistances. Table 1. Left heart postnatal remodeling zones LV= left ventricle. 2. The right heart circuit: contrarily to the left, the right heart could adjust blood volume and shear rates at 5 different anatomical zones according to its physiological demands. In antenatal period, the right heart receives and pumps in equal rates more volume than the left, but keeps low remodeling due to pressure release through physiological shunts (Clark, 1987).

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Biophysics by A. Misra


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