1. Apparatus Setup
Jason Quill
Eric Richardson

2. System Schematic

3. Learning to Use the System
Start by learning the day after setup
Familiarize yourself with the subsystems and components
Take your time doing it, there’s no rush
Then learn to set up everything on the day of the study

4. Apparatus Setup: Day of Study
Jason Quill

5. Overview Rack setup Millar sensors Other pressure transducers
Flow probes
ECG
Defib. Patches
Oxygen sensor
Camera setup
Reservoir sensor
Kreb’s cart
Oxygen
Prewarming chamber
Reservoir
Prime the pumps
Left side pump
Right side pump
Heating Circuit
Hook up cannulated Heart

6. Rack Setup Transport from surgical suite
Start IOX and any other programs needed
Attach sensors and calibrate

7. Reservoir Sensor Melt a hole in the reservoir using the soldering iron
Place the reservoir sensor in the reservoir
Turn on the sensor

8. Kreb’s Cart Wheel in from across the hall Retrieve pump and connect
Do not plug in yet!
Turn on oxygen
Drop aerator into Kreb’s container
Clamp oxygen line so that flow only goes to the Kreb’s container (don’t be wasteful)
Make sure float sensor in the prewarming chamber is attached

9. Filling the System Prewarming Chamber Reservoir
Make sure the float sensor is connected
Plug in the pump
Reservoir
Make sure the reservoir sensor is connected and active
Turn the orange valve to fill the reservoir

10. Starting the Pumps Prime the Pumps Left Side Pump Right Side Pump
Lower the pump heads to get the air out
Clamp the outlet to prevent air from coming back in
Left Side Pump
Fill the left side chamber
Switch the clamp
Keep the reservoir filled (or you’ll get to prime the pumps again)
Right Side Pump
Adjust the flow in the right side chamber so that it is slowly going into the overflow tank
Keep the reservoir filled

11. Heating Circuit Pumps can be turned on at any time
Heater should not be turned on until the heart is cannulated and ready to be attached to the apparatus

12. Calibration Millar sensors (LVP/RVP) Pressure transducers
Connect, wrap with Parafilm
Zero using syringe
Calibrate at: RVP=100; LVP=200
Pressure transducers
Flush and zero
Calibrate at: RAP=100; PAP=100; ART=200

13. Calibration Flow sensors Oxygen tank sensor ECG Camera Setup
On the flow sensor board push the zero button, check IOX values
Push the 10 button, check IOX values
Push Meas.
Oxygen tank sensor
Zero transducer (open to atmosphere)
Check that alarm is on and limits are acceptable
ECG
No calibration required
Camera Setup
Attach side-view camera lens (and any other required cameras)
White balance

14. Attaching the Heart
Paul will cannulate the heart with the assistance of a grad. Student
Turn on the Heater in the heating circuit and the heat sensor (blue box)
Once the cannula are attached to the apparatus, assist Paul is removing air from the heart

15. Clean up!
Rinse
Wash
Ethanol Rinse
Try to stay dry

16. Apparatus Setup: Day After Study
Jason Quill
Eric Richardson

17. Overview Oxygenator Setup Heating Circuit Systemic Lines
Reservoir Return Lines
Oxygen Circuit
Connections to the Heart
Sensors
Clamps

18. Oxygenator Setup Key located at exit of the lab Located in storeroom
Remove top part put in drawer

19. Oxygenator Setup Pink to pink Put in screw cap on top
Place in visible heart apparatus

20. Heating Circuit “Bottom to top” Quick Releases
Two tubes – connect tubes to reservoir before connecting quick releases

21. Systemic lines
Inflow to the pump drains the reservoir
RESERVOIR

22. Left pump outflow enters the oxygenator
Systemic lines
Left pump outflow enters the oxygenator
Left pump outflow
Oxygenator inlet

23. Reservoir Return Lines
All return lines go to the top of the reservoir
One of two pulmonary afterload holding chamber returns
Second pulmonary afterload holding chamber return
Aortic overflow return
Left side holding chamber overflow return
Right holding chamber overflow return 1 2 3 4 5

24. Pulmonary Afterload Holding Chamber Placement
The only holding chamber needing to be attached to the visible heart apparatus
Clamps at location shown

25. Reservoir Return Lines
All return lines go to the top of the reservoir
“orange to orange”: the orange valve line returns to the top (central) orange port of the reservoir

26. Oxygen Circuit Oxygen inlet from ceiling 3 outlet lines (2 shown)1
Oxygen inlet from ceiling
3 outlet lines (2 shown)
Oxygen outlet
Oxygen Outlet
Oxygen Inlet

27. Oxygen Circuit Oxygen supply to the oxygenator
The oxygenator supply tube is the longest of the oxygen tubes and runs along the far side of the apparatus with respect to the oxygen inlet 1

28. Oxygen Circuit Right side holding chamber oxygen supply
Left side holding chamber oxygen supply
Prewarming chamber oxygen supply 1 2 3
Note: the oxygen supply for the right side holding chamber and the left side holding chamber share a supply line and the individual chambers’ oxygen supply pressure is controlled through clamps on the lines.

29. Connections to the Heart1 2 3 4
Pulmonary artery
Pulmonary vein
Aorta
IVC
Note: the Ys need to be inserted to monitor pressures during experiments. Many clamp positions can be seen from the picture as well

30. Sensors Pressure sensors Temperature probe
See “Connections to the Heart” slide for Y placement
Temperature probe
Located at the bottom of the oxygenator
Temperature Probe

31. Clamps Clamps at inlets to heart and outlets to drain during start up
Langendorff perfusion pathway
Working mode

32. Langedorff Mode

33. Langedorff Mode

34. Working Mode

35. Words of “Wisdom”
Its easier to remember the connections in the visible heart apparatus if you can relate the components of the system to the anatomy and physiology of the cardiovascular system.
When your memory fails, look for a connection that fits and figure out if its wrong later…unless you are afraid of getting your shoes wet