Extracorporeal circulation by peripheral cannulation before redo sternotomy: Indications and results

Abstract

In selected patients, cardiopulmonary bypass before resternotomy is a valid and reproducible option to render cardiac reoperations safer and more expeditious in the reentry phase. The absence of cannulae in the operating field makes the procedure more comfortable. The liberal use of this strategy is recommended in redo cases.

Reoperation of the proximal aorta: impact of presternotomy extracorporeal circulation on clinical outcomes

“…Interestingly, both Luciani et al 4 and Kuralay et al 5 showed a shorter ICU stay for patients in the presternotomy ECC group. This could be due to their reduced reentry injuries and associated morbidity.…”

“…3,6 Several authors have suggested institution of ECC before a resternotomy by cannulation of the peripheral arteries during redo cardiac surgery. 4,5 However, only a few studies have so far directly quantifi ed its clinical benefi t and drawbacks, 4 and no study has focused specifi cally on the aortic pathology.…”

“…Two major comparative studies analyzed the impact of presternotomy ECC during redo cardiac surgery for 4 and Kuralay et al 5 showed a longer ECC time with presternotomy extracorporeal circulation. Our results may be due to the fact that our study was underpowered.…”

“…3 Although several authors have advocated the use of extracorporeal circulation (ECC) before a sternotomy for redo cardiac surgery, there are only a few studies that have directly analyzed its effects on clinical outcomes. 4,5 No article has previously specifi cally focused on redo proximal aortic surgery. The aim of this study was to compare the early results of redo proximal aortic surgery based on applying ECC before versus after a redo sternotomy.…”

Timing and Technique of Pulmonary Valve Replacement in the Patient With Tetralogy of Fallot

“…Ultrasound studies should be routinely performed to confirm patency of the femoral vessels. 32 Patients should have alternate cannulation sites identified and prepped into the field before resternotomy. In addition to the femoral vessels, the axillary artery can be used.…”