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Ann Thorac Surg 2001;71:1267-1271
© 2001 The Society of Thoracic Surgeons

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Original article: cardiovascular

Assisted venous drainage cardiopulmonary bypass in congenital heart surgery

^a Division of Cardiovascular Surgery, Miami Children’s Hospital, Miami, Florida, USA

Accepted for publication September 14, 2000.

Address reprint requests to Dr Hannan, Division of Cardiovascular Surgery, Miami Children’s Hospital, 3200 SW 60 Ct, Ste 102, Miami, FL 33155-4069
e-mail: rhannan001{at}aol.com

Background. A novel active venous drainage perfusion circuit was designed to achieve effective venous return through small venous cannulas. The efficacy and safety of this new system was investigated and compared with a conventional gravity drainage system.

Methods. Four hundred consecutive patients undergoing open heart repair of congenital heart lesions by one surgeon were studied. The first 200 patients were supported by gravity drainage and the next 200 patients were supported by assisted venous drainage. No patient in the time period was excluded from the study.

Results. The two groups did not differ significantly in weight, bypass time, or cross-clamp time. Priming volumes were less in the assisted group than in the gravity group (576 ± 232 mL versus 693 ± 221 mL, p < 0.001). Venous cannula size was smaller in the assisted group when compared with the gravity group (33.2F ± 7.4F versus 38.5F ± 7.1F, p < 0.001). There was a trend to lower operative mortality in the assisted drainage group (5 of 200, 2.5% versus 11 of 200, 5.5%; p = 0.10). Hospital stay and pulmonary, infectious, and neurologic complications were comparable in both groups. Cardiac complications were less common in the assisted group than in gravity group (22 of 200, 11% versus 38 of 200, 19%; p = 0.017). Hematologic complications were less common in the assisted group than the gravity group (6 of 200, 3% versus 19 of 200, 9.5%; p < 0.01).

Conclusions. These findings suggest that assisted venous drainage is safe in congenital heart operations and facilitates the use of smaller venous cannulas.

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Invited commentary

J. William Gaynor
Ann. Thorac. Surg. 2001 71: 1271-1272. [Extract] [Full Text] [PDF]

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