HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Erkan Kuralay Cengiz Bolcal Ertugrul Özal Ufuk Demirkilic Mehmet Arslan Harun Tatar Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kuralay, E. Articles by Tatar, H. Search for Related Content PubMed PubMed Citation Articles by Kuralay, E. Articles by Tatar, H. Related Collections Extracorporeal circulation

Ann Thorac Surg 2004;77:977-981
© 2004 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Cardiac reoperation by Carpentier bicaval femoral venous cannula: GATA experience

^a Department of Cardiovascular Surgery, Gülhane Military Medical Academy, Ankara, Turkey
^b Department of Anesthesiology, Gülhane Military Medical Academy, Ankara, Turkey
^c Department of Biostatistics and Public Health, Gülhane Military Medical Academy, Ankara, Turkey

Accepted for publication September 8, 2003.

^* Address reprint requests to Dr Kuralay, Yazanlar sokak No = 31, 11, Asagi Ayranci, Ankara, Turkey 06540
e-mail: ekural{at}gata.edu.tr

BACKGROUND: Division of the sternum is primarily a blind procedure in reoperation and carries an increased risk of injury for major cardiac structures in the presence of adhesions between the posterior table and the heart.

METHODS: Two hundred patients were randomly divided into two groups. Cardiopulmonary bypass was established through the femoral artery and vein in group 1 (n = 100) patients before sternal reentry. Carpentier dual-stage femoral venous return cannula was used in all group 1 patients. Cardiopulmonary bypass was performed after sternal reentry in group 2 (n = 100) patients.

RESULTS: Six severe cardiac injuries developed in group 2. Cardiopulmonary bypass time was 93 ± 9 minutes in group 1 and 71 ± 11 minutes in group 2 (p = 0.011), and the operation time was 155 ± 23 minutes in group 1 and 185 ± 32 minutes in group 2 (p = 0.024). Inotropic therapy was required in 52 patients in group 1 and 76 patients in group 2 (p = 0.032). Average chest drainage was 450 ± 135 mL in group 1 and 850 ± 250 mL in group 2 (p < 0.001). Average fresh whole blood transfusion was 3.3 ± 1.2 U in group 1 and 5.8 ± 0.9 U in group 2 (p = 0.033). Average intensive care unit stay was 2.2 ± 1.3 days in group 1 and 4.5 ± 2.3 days in group 2 (p = 0.025). Average hospital stay was 7.3 ± 2.4 days in group 1 and 9.1 ± 3.1 days for group 2 (p = 0.011).

CONCLUSIONS: Cardiopulmonary bypass by bicaval Carpentier femoral venous cannula before resternotomy not only allows adequate cardiopulmonary bypass flow but also significantly reduces the risk of cardiac injury and catastrophic hemorrhage and allows safe reopening. Although this procedure increases cardiopulmonary bypass time, the operation time, bleeding, and blood transfusion requirement are significantly reduced.

This article has been cited by other articles:

				L. K. von Segesser, E. Ferrari, D. Delay, O. Maunz, J. Horisberger, and P. Tozzi Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 635 - 640. [Abstract] [Full Text] [PDF]

				N. Luciani, A. Anselmi, R. De Geest, L. Martinelli, M. Perisano, and G. Possati Extracorporeal circulation by peripheral cannulation before redo sternotomy: Indications and results J. Thorac. Cardiovasc. Surg., September 1, 2008; 136(3): 572 - 577. [Abstract] [Full Text] [PDF]