Clinical evaluation of minimized extracorporeal circulation in high-risk coronary revascularization: impact on air handling, inflammation, hemodilution and myocardial function

Abstract

Mini-CPB provided a comfort and safety level similar to conventional control via satisfactory air handling, attenuated inflammatory response and hemodilution, with a better clinical outcome in patients undergoing high-risk CABG.

Impact of the intensity of microemboli on neurocognitive outcome following cardiopulmonary bypass

“…We have documented GME detection in different types of extracorporeal circuits in our previous publications. 6,7 Strategies to remove air bubbles during CPB and to potentially decrease neurologic complications include attaining the Trendelenburg position, carotid compression, ascending aorta venting, stopping the pump if the arterial catheter is filled with air, de-airing of the heart if air is from the heart, increasing the mean arterial pressure, initiating pulsatile flow, the use of 100% oxygen, packing the head in ice, rapid systemic cooling to electroencephalographic near silence, and/or retrograde cerebral perfusion. We have employed all the current precautions for every single patient.…”

“…POCD is also reported to be insignificant in routine patients, but significantly higher in high-risk groups in many of the previous studies. 6 Clinical indicators are, unfortunately, late signs of embolism. Moreover, they are non-specific.…”

Perioperative blood conservation strategies in pediatric patients undergoing open-heart surgery: impact of non-autologous blood transfusion and surface-coated extracorporeal circuits

“…It has already been demonstrated, from our previous studies comparing minimized CPB systems to conventional systems, that cardiotomy suction may have a much greater impact on the inflammatory reaction than surface coating of the CPB system. It might be speculated that the results concerning TNFalpha (and to some extent IL-6) were not very much different among the groups because the use of cardiotomy suction and vent would have an additional effect 15 .…”

Less invasive coronary artery revascularization with a minimized extracorporeal circulation system: preliminary results of a comparative study with off-pump-procedures

“…Logically, the question always rises as to whether a lower number of grafts in myocardial revascularization with or without the use of CPB may be associated with technical or anatomical difficulties, and thus represents a risk of incomplete myocardial revascularization with potentially inferior outcome. Even if incomplete revascularization might be unavoidable in some specific instances, is was shown in a recent subgroup analysis of the well-respected SYNTAX data [33] that in surgically treated patients adverse events in terms of MACCE and need for repeat revascularization are not significantly increased following IR as compared to CR.…”