This result could not be directly applied to the in vivo situation; however, clinical investigation with alternate RA or RV injections yielded similar phenomena. This strongly suggests that RA injection or calculation of mean value may lead to underestimation of the actual RVEF; however, we did not compare thermal RVEF with those obtained from other […]

We did not have any data as to how this respiratory pattern would affect RVEF during the patients’ respiratory cycles; however, we injected the cold water irrespective of respiratory cycle. It is unlikely that the cold water was always injected at any one point of a respiratory cycle and our data could be evaluated as […]

How Did the Injection Timing Affect RVEF? Stroke volumes are considered to vary stroke by stroke, but it is more reasonable to assume that they fluctuate physiologically with respiratory movement. CO could be calculated as the mean of a few strokes, and thereby might be affected less by respiration than stroke volume, as previously stated […]

RV injection involved another problem, that is whether CO could be accurately measured. Some authors have reported that there is a difference in CO between RA and RV injections; however, we could not find any such difference. The cause of discrepancy between our results and theirs is not clear and more thorough investigation into this […]

In relation to these considerations, Rapaport proposes that it is probably useless to inject the indicator into the atrium near the atrioventricular valve in an attempt to obtain better mixing, and on the other hand, atrial injection can cause inaccuracy in the measurement of residual fraction and therefore end-diastolic volume. Our results indicated that the […]

Salgado and Galletti verified the reliability of thermal EF in an artificial heart composed of a rubber balloon enclosed in a glass container connected to a piston pump, and in their figures we find out no evidence of successively changing EFs because the EF is set at less than 0.4. In the inflow circuit injection, […]

However, by analyzing thermal washout curves obtained in patients, we observed that successive EFs increased in RA injection and that EF3 was small in RV injection. A similar phenomenon was observed in the model experiment when the indicator was injected just above the inflow valve (above the tricuspid valve); EF2 was the largest and closest […]

The successive EFs obtained in a washout curve are naturally fluctuating because successive stroke volumes and EFs vary in an actual heart unlike the situation in a mechanical analogue, and hence we consider that calculation of the mean EF from a few successive EFs is reasonable. However, if there were any significant relationships between successive […]

Correlation between the Three Successive EFs in the Model Heart Less variation in the three successive EFs was apparent in EFs obtained with the low preset EF values of 0.4 or 0.44; however, a successive decrease from EF1 to EF3 was characteristic of EFs obtained with the preset EF value of 0.62 (Table 3). The […]

Measurement in Patients A total of 28 paired values were obtained in the ten patients. Duplicate paired measurement was performed in two patients and in the others triplicate paired measurement was undertaken. In comparison of serial EFs in RA or RV injection, EF1 was found to be the lowest in RA injection; however, in RV […]