Minimized cardiopulmonary bypass combined with a smart suction device: the future of cardiopulmonary bypass?

Stalder, Mario; Gygax, Erich; Immer, Franz F; Englberger, Lars; Tevaearai, Hendrik; Carrel, Thierry P (2007). Minimized cardiopulmonary bypass combined with a smart suction device: the future of cardiopulmonary bypass? Heart surgery forum, 10(3), E235-8. Charlottesville, Va.: Forum Multimedia Pub. 10.1532/HSF98.20070703

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OBJECTIVE: The standard heart-lung machine is a major trigger of systemic inflammatory response and the morbidity attributed to conventional extracorporeal circulation (CECC) is still significant. Reduction of blood-artificial surface contact and reduction of priming volume are principal aims in minimized extracorporeal circulation (MECC) cardiopulmonary bypass systems. The aim of this paper is to give an overview of the literature and to present our experience with the MECC-smart suction system. METHODS AND RESULTS: At our institution, 1799 patients underwent isolated coronary artery bypass grafting (CABG) surgery, 1372 with a MECC-smart suction system and 427 with CECC. All in-hospital data were assessed and the results were compared between the 2 groups. Patient characteristics and the distribution of EuroSCORE risk profile in our collective were similar between both groups. Average age in the MECC collective was 67.5 +/- 11.4 years and average EuroSCORE was 5.0 +/- 1.5. Average number of distal anastomoses was similar to the average number encountered in patients undergoing CABG surgery with CECC (3.3 +/- 1.0 for MECC versus 3.2 +/- 1.1 for CECC; P = ns). Myocardial protection is superior in MECC patients with lower postoperative maximal cTnI values (11.0 +/- 10.8 micromol/L for MECC versus 24.7 +/- 25.3 micromol/L for CECC; P < .05). Postoperative recovery was faster in patients operated on with the MECC-smart suction system and discharge from the hospital was earlier than for CECC patients (7.4 +/- 1.9 days for MECC versus 8.8 +/- 3.8 days for CECC; P < .05). CONCLUSIONS: The MECC-smart suction system is a safe perfusion technique for CABG surgery. In patients operated on with this system, the clinical outcome seems to be better than in patients operated on with CECC. This promising and less damaging perfusion technology has the potential to replace CECC systems in CABG surgery.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Stalder, Mario; Immer, Franz F.; Englberger, Lars; Tevaearai, Hendrik and Carrel, Thierry

ISSN:

1098-3511

ISBN:

17599899

Publisher:

Forum Multimedia Pub.

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:56

Last Modified:

04 May 2014 23:16

Publisher DOI:

10.1532/HSF98.20070703

PubMed ID:

17599899

Web of Science ID:

000249123500019

URI:

https://boris.unibe.ch/id/eprint/23965 (FactScience: 45441)

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