Recycling of cardiopulmonary bypass cannulae: a risk-benefit analysis.
OBJECTIVE
To determine whether recycling of arterial and venous cannulae for cardiopulmonary bypass is associated with an increased risk of infectious complications after open heart surgery.


METHODS
A prospective, risk-benefit analysis.


METHODS
A university teaching hospital.


METHODS
Five hundred and forty patients underwent a variety of non-transplant cardiac operations, which were performed by one surgeon between October 1988 and July 1993.


METHODS
Standard techniques of open heart surgery were used. Ascending aortic and vena caval cannulae and the multiple perfusion device for administering cardioplegia down saphenous vein bypass grafts were reused an average of 10 to 15 times after sterilization with ethylene oxide after each use.


METHODS
The postoperative morbidity and mortality and the estimated savings achieved by recycling the cannulae.


RESULTS
The operative mortality (total in hospital plus within 30 days of operation) was 2.8% (15 patients). There were no cases of endocarditis; there was only one case of superficial presternal infection and one case of mediastinitis. Gram-negative organisms were cultured from the blood of two patients and gram-positive organisms from the blood of one patient. Only one patient died of an infectious complication. The estimated cost saving during the study period was more than $50,000.


CONCLUSIONS
The risk of wound and hematogenous infection after open heart surgery in which recycled cannulae are used is less than 1%. This rate is lower than that quoted in most recent reports. Reuse of heart-lung bypass cannulae may realize substantial cost savings without detriment to the patient.
Novick
R J
RJ
Division of Cardiovascular-Thoracic Surgery, University Hospital, London, Ont.
D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D003365:Costs and Cost Analysis; D004697:Endocarditis, Bacterial / Q000209:etiology; D017743:Equipment Reuse; D005069:Evaluation Studies as Topic; D006324:Heart Arrest, Induced / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation; D006801:Humans; D007239:Infections / Q000209:etiology; D008480:Mediastinitis / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology