Minimal invasive extracorporeal circulation (MiECC): the state-of-the-art in perfusion

Anastasiadis, Kyriakos; Argiriadou, Helena; Deliopoulos, Apostolos; Antonitsis, Polychronis

doi:10.21037/jtd.2019.01.66

Cited by 32 publications

(32 citation statements)

References 22 publications

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“…It is obvious that optimal perfusion is not an accessory, but a core component of MICS strategy. The advancement from conventional CBP (cCPB) towards an improved perfusion circuit is described, by some groups, as "optimized ECC" (opECC) (13). This represents an upgraded and more versatile perfusion circuit that integrates selected CPB technological advancements to the standard perfusion circuit (Figure 1) (14).…”

Section: Myocardial Protectionmentioning

confidence: 99%

“…This translates to a "prevent rather than correct" policy. The ultimate target when combining MICS with MiECC is to operate all case-mix (low-and high-risk patients and complex procedures) as comfortably and effectively, in terms of hemodynamic and metabolic integrity, as operating a low-risk case (13).…”

Section: Goal-directed Perfusion (Gdp)mentioning

confidence: 99%

“…The superiority of MiECC over cCPB in clinical practice has been well-established throughout the last decade with large-scale randomized studies and meta-analyses (13).…”

Section: Comparison Of Miecc and Ccpbmentioning

confidence: 99%

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From less invasive to minimal invasive extracorporeal circulation

Anastasiadis¹,

Antonitsis²,

Deliopoulos³

et al. 2021

J Thorac Dis

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Development of minimally invasive cardiac surgery (MICS) served the purpose of performing surgery while avoiding the surgical stress triggered by a full median sternotomy. Minimizing surgical trauma is associated with improved cosmesis and enhanced recovery leading to reduced morbidity. However, it has to be primarily appreciated that the extracorporeal circulation (ECC) stands for the basis of nearly all MICS procedures. With some fundamental modification and advancement in perfusion techniques, the use of ECC has become the enabling technology for the development of MICS. Less invasive cardiopulmonary bypass (CPB) techniques are based on remote cannulation and optimization of perfusion techniques with assisted venous drainage and use of centrifugal pump, so as to facilitate the demanding surgical maneuvers, rather than minimizing the invasiveness of the CPB. This is reflected in the increased duration of CPB required for MICS procedures. Minimal invasive Extracorporeal Circulation (MiECC) represents a major breakthrough in perfusion. It integrates all contemporary technological advancements that facilitate best applying cardiovascular physiology to intraoperative perfusion. Consequently, MiECC use translates to improved end-organ protection and clinical outcome, as evidenced in multiple clinical trials and meta-analyses. MICS performed with MiECC provides the basis for developing a multidisciplinary intraoperative strategy towards a "more physiologic" cardiac surgery by combining small surgical trauma with minimum body's physiology derangement. Integration of MiECC can advance MICS from non-full sternotomy for selected patients to a "more physiologic" surgery, which represents the real face of modern cardiac surgery in the transcatheter era.

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Section: Myocardial Protectionmentioning

confidence: 99%

Section: Goal-directed Perfusion (Gdp)mentioning

confidence: 99%

See 1 more Smart Citation

From less invasive to minimal invasive extracorporeal circulation

Anastasiadis¹,

Antonitsis²,

Deliopoulos³

et al. 2021

J Thorac Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Applying POC heparin-protamine and coagulation management when using MiECC in combination with continuous transesophageal echocardiography and in-line intraoperative monitoring, upgrades MiECC from a system to a procedure and defines the so called "MiECC strategy" (5). This multidisciplinary approach is translated into a "prevent rather than correct" perioperative management, through preservation of metabolic, coagulation and microcirculatory integrity that ultimately leads to improved end-organ protection and an optimal clinical outcome.…”

Section: The Value Of Poc Coagulation Management During Surgery With mentioning

confidence: 99%

“…Our department is a leading institution in the field of MiECC research and technology that is routinely applied to all types of cardiac surgical procedures (4). We implement MiECC use in the context of a multidisciplinary perioperative strategy for attaining "more physiologic" cardiac surgery, as presented earlier in this focused issue (5).…”

Section: Introductionmentioning

confidence: 99%