Single Catheter Gravity Drainage of the Right Atrium or Right Ventricle During Total Cardiac Bypass

Conventional methods of cannulation preparatory to cardiac bypass with a pumpoxygenator involve individual catheterization of the vena cavae. Drainage is then instituted by pump action or gravity. A method is presented whereby operations on left heart structures, such as the mitral valve or the aortic valve area, may be simplified through the use of single catheter drainage of the right atrium or right ventricle. Gravity siphonage is employed and the "venous" blood is collected in a dependent reservoir from where it may be pumped into an artificial or a biological oxygenator. Laboratory experiences with this setup showed it to be a satisfactory device in circuits employing an artificial oxygenator and in others in which the animal's own lungs were the oxygenating element. Encouraged by these results, we have used the single catheter method of drainage in patients suffering from mitral or aortic valve lesions. Three precautions should be observed during its use: 1. This method is applicable only to surgery on left heart structures in the presence of an intact septum. 2. The catheter employed and the drainage tubing should have a siphoning capacity compatible with the perfusion flows contemplated. 3. Care should be exercised in the correct placing and anchoring of the drainage catheter to prevent interruption of siphonage during operation. A simple safety device designed to re-establish siphonage by suction is illustrated.