title: Second generation of minimal invasive extracorporeal circuit: pilot study resting heart system.
abstract: Cardiopulmonary bypass (CPB) has evolved from a complex multifunctional system to the minimally invasive extracorporeal circuit (MIEC). Concerns currently exist regarding the technically demanding nature of off-pump coronary artery bypass (OPCAB) procedures, the quality of anastomosis associated with it, and the difficulty in achieving "complete revascularization." Recognizing these issues, the so-called mini-CPB concept has evolved in an effort to offer the perceived benefits of OPCAB with the technical advantages of CPB and at the same time minimize the adverse effects of full-scale CPB. The first generation of MIEC had an inherited risk of gas embolisms. Therefore, there was the introduction of the resting heart system (RHS), the main characteristic of which is the venous air removal device. The aim of this study was to describe our early experience, feasibility, and safety with this system to help others who are considering introducing this technique into their clinical practice. Using this system, we operated on 30 consecutive patients. Moderate hypothermia (33 degrees C) CPB and cold intermittent antegrade cardioplegia was used. No technical incidents were encountered. One death from multiorgan failure occurred in a patient operated on for a thoraco-abdominal aneurysm. Our own short-term experience with the RHS has been very favorable, and we will continue to explore this development in CPB technology.
authors.affiliation: Service de Chirurgie Cardiovasculaire, Hôpital Cardiologique, CHRU de Lille, France. g-fayad@chru-lille.fr
authors.forename: George
authors.initials: G
authors.lastname: Fayad
authors.forename: Thomas
authors.initials: T
authors.lastname: Modine
authors.forename: Ghassan
authors.initials: G
authors.lastname: Naja
authors.forename: Benoit
authors.initials: B
authors.lastname: Larrue
authors.forename: Richard
authors.initials: R
authors.lastname: Azzaoui
authors.forename: Francis
authors.initials: F
authors.lastname: Crépin
authors.forename: Christophe
authors.initials: C
authors.lastname: Decoene
authors.forename: Lots
authors.initials: L
authors.lastname: Benhamed
authors.forename: Mohamed
authors.initials: M
authors.lastname: Koussa
authors.forename: Terence
authors.initials: T
authors.lastname: Gourlay
authors.forename: Henry
authors.initials: H
authors.lastname: Warembourg
mesh_terms: D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D010865:Pilot Projects