Aortic surgery using total miniaturized cardiopulmonary bypass.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.
Issitt
Richard W
RW
Department of Clinical Perfusion Science, Hammersmith Hospital, London, United Kingdom.
Mulholland
John W
JW
Oliver
Martin D
MD
Yarham
Gemma J
GJ
Borra
Philippa J
PJ
Morrison
Paul
P
Dimarakis
Ioannis
I
Anderson
Jon R
JR
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery; D016913:Blood Component Transfusion / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D004867:Equipment Design; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D017202:Myocardial Ischemia / Q000601:surgery; D012189:Retrospective Studies