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Ann Thorac Surg 2008;86:627-631. doi:10.1016/j.athoracsur.2008.03.015
© 2008 The Society of Thoracic Surgeons
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New Technology

Aortic Surgery Using Total Miniaturized Cardiopulmonary Bypass

Richard W. Issitt, BSc(Hons)a,d, John W. Mulholland, BEnga,d,*, Martin D. Oliver, BMedScia,d, Gemma J. Yarham, BSc(Hons)b, Philippa J. Borra, FRCAb, Paul Morrison, FRCA, Ioannis Dimarakis, MDc, Jon R. Anderson, FRCS(CTh)c

a Department of Clinical Perfusion Science, Hammersmith Hospital, London, United Kingdom
b Department of Anesthesia, Hammersmith Hospital, London, United Kingdom
c Department of Cardiac Surgery, Hammersmith Hospital, London, United Kingdom
d London Perfusion Science, London, United Kingdom

Accepted for publication March 7, 2008.

* Address correspondence to Dr Mulholland, Department of Clinical Perfusion Science, Cardiac Theatres, 2nd Floor, Block A, Hammersmith Hospital, 150 Du Cane Rd, London, W12 0HS, United Kingdom (Email: john{at}londonperfusionscience.com).

Purpose: Few centers have attempted aortic surgery using miniaturized cardiopulmonary bypass (MCPB) systems due to concerns of air handling. The extra corporeal circuit optimized (ECCO) total MCPB system uses a venous air removal device and a parallel soft-shell reservoir that allows for venting of the heart. At our institution, total MCPB is used for all coronary artery bypass graft patients. Our objective was to assess the suitability of the ECCO total MCPB system during aortic surgery.

Description: Fifty consecutive and unselected aortic procedures using the ECCO system were undertaken. Surgical feasibility, air removal ability, and blood transfusion requirements were audited to determine the efficacy of this technique.

Evaluation: The bypass time was 81.6 ± 28.0 minutes and the ischemic time was 56.7 ± 18.9 minutes. Total MCPB handled 1,910 ± 404 mL of vented blood with 96 venous air removal device activations noted. The blood product transfusion rate was 12%, which was below the surgical transfusion rate for our unit. There were no complications.

Conclusions: Aortic surgery can be undertaken safely and effectively using the ECCO total MCPB system.






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