280 
SURGERY AND TRANSPLANTATION 
Figure 4. — Showing the B-LHAD fixed the chest wall. Six tubes attached to the device are compressed air lines 
connected to the control-driving system back of the calf. The calf's head is on the right. 
clamp was then removed restoring normal cir- 
culation, since the distal anastomosis had al- 
ready been completed. The temporary occlusion 
of the venae cavae was released. Air was re- 
moved from the unit through a needle inserted 
at the highest point of the device which was on 
the inlet side adjacent to the pumping chamber. 
A continuous silk suture was placed around the 
aorta through the Dacron cuff at the edge of the 
adaptor ring. When suturing was completed, 
the ring was split and removed. The distal end 
of the ascending aorta was closed by a continu- 
ous suture. 
Calves 
In calves, extracorporeal circulation was re- 
quired for the following reason: the brachio- 
cephalic artery is the only artery branching 
straight off from the ascending aorta. No other 
branch comes off from the aortic arch. Since the 
ascending aorta is extremely short, there is no 
room to apply the quick connection technique 
developed in dog experiments. In order to ob- 
tain sufficient working room around the ascend- 
ing aorta, the brachiocephalic artery and the 
aortic arch were dissected and occluded tempo- 
rarily during connection of the inlet side. This 
procedure required two arterial lines to perfuse 
each upper and lower part of the body (Figure 
6). One cannula was inserted into the internal 
thoracic artery, and a side tube attached distal 
to the outlet valve was used to perfuse the lower 
part of the body via the descending aorta. Hep- 
arin (3 mg/kg of body weight) was adminis- 
tered intravenously prior to cannulation. For 
venous drainage one thick cannula (ID5/8") 
was inserted into the right atrium through the 
atrial appendage. A vent cannula (ID 1/4") 
was inserted into the left ventricle through the 
left atrial appendage. 
