title: Heparin-bonded circuits without a cardiotomy: a description of a minimally invasive technique of cardiopulmonary bypass.
abstract: The deleterious effects of cardiotomy suction have been well recognized and well documented for some time. The use of cardiotomy suction results in the exposure of blood to the defoaming sock, aspiration of stagnant pericardial blood into the systemic circulation, and the entrainment of both fatty and gaseous microemboli. The purpose of this paper is to describe a technique using heparin-bonded cardiopulmonary circuits (HBCs) without the use of a cardiotomy reservoir or cardiotomy suction. Our group has previously demonstrated improved clinical outcomes using HBCs and a low-dose anti-coagulation protocol. It is our goal to further improve clinical outcomes and further attenuate the deleterious effects of cardiopulmonary bypass by eliminating the potential complications attributed to the use of cardiotomy suction.
authors.affiliation: Department of Cardiothoracic Surgery, Boston University Medical Center, Massachusetts 02118, USA. kelilly@bmc.org
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Lilly
authors.forename: Paul J
authors.initials: PJ
authors.lastname: O'Gara
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Treanor
authors.forename: Richard
authors.initials: R
authors.lastname: Crowley
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Reardon
authors.forename: Oz M
authors.initials: OM
authors.lastname: Shapira
authors.forename: Shukri F
authors.initials: SF
authors.lastname: Khuri
authors.forename: Gabriel S
authors.initials: GS
authors.lastname: Aldea
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Shemin
mesh_terms: D002315:Cardiopulmonary Bypass / Q000295:instrumentation* / Q000379:methods; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D004867:Equipment Design / Q000592:standards; D006112:Gravitation; D006493:Heparin; D006801:Humans; D008722:Methods; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D013396:Suction / Q000009:adverse effects
chemical_list: D020099:Coated Materials, Biocompatible; D006493:Heparin