Modified cardiopulmonary bypass with low priming volume for blood conservation in cardiac valve replacement surgery

Yang, Kè; Huang, Honghao; Dai, Ruiwu; Zhang, Jinbao; Wei, Xiaofeng; Gao, Feng; Wu, Xiaochen; Wang, Fan; He, Siyi; Xin, Mei

doi:10.1186/s13019-023-02175-8

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…The adverse effects CPB, such as hemodilution, have led researchers to explore modified techniques. Yang, et al, [24] introduced a modified CPB system with low priming volume to minimize hemodilution during open cardiac surgery [24]. This retrospective study examined the impact of reduced priming volume on patient outcomes.…”

Section: Quality Improvement Initiativesmentioning

confidence: 99%

Exploring Perfusion Safety: A Review of Clinical and Non-Clinical Factors with Emphasis on Quality Improvement

Butt

2023

J Cardiol Cardiovasc Res.

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This literature review examines perfusion safety in cardiothoracic surgery, with a primary focus on cardiopulmonary bypass (CPB) and circulatory devices. PRISMA guidelines were followed and various databases, including PubMed, MEDLINE, and Google Scholar, were searched using relevant keywords to identify pertinent studies and literature on the subject. The review traces the historical development of perfusion techniques and underscores the importance of equipment factors, personnel considerations, and perfusion management strategies in ensuring patient safety during CPB and circulatory device usage. Clinical aspects of perfusion safety, encompassing equipment safety features, temperature management, anticoagulation, and blood conservation, are discussed. Non-clinical aspects, including the implementation of standardized protocols, robust training structures, positive team dynamics, and the fostering of a safety-oriented culture, are also examined. Quality improvement initiatives for blood conservation, monitoring, and incident reporting are explored, along with an acknowledgment of the significant contributions of major perfusion societies and boards (AmSECT, SCPS, EBCP) in establishing standards and promoting excellence in the field. Challenges related to device design, patient selection, and perioperative management are addressed, highlighting the need for standardized practices and ongoing research to enhance perfusion safety. This comprehensive review underscores the enduring commitment to advancing perfusion safety and quality through systematic research, education, and collaborative efforts in cardiothoracic surgery.

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Section: Quality Improvement Initiativesmentioning

confidence: 99%

Exploring Perfusion Safety: A Review of Clinical and Non-Clinical Factors with Emphasis on Quality Improvement

Butt

2023

J Cardiol Cardiovasc Res.

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Con: Is Minimal Invasive Extracorporeal Circulation Superior to Conventional Cardiopulmonary Bypass in Cardiac Surgery?

Blanco,

Vives

2024

Journal of Cardiothoracic and Vascular Anesthesia

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Vacuum assisted and gravitational venous drainage in aortic valve surgery: A propensity-match study

Silvano,

Malvindi,

Mazzocca

et al. 2024

Perfusion

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Introduction Vacuum assisted venous drainage (VAVD) is widely adopted in minimally invasive cardiac surgery. VAVD enables the advantage of using smaller cannulae in a reduced surgical field while allowing satisfactory drainage and pump flow. The production of gaseous micro-emboli is a recognized risk associated with VAVD, however no difference in clinical endpoints have been reported between patients operated on with gravity venous drainage (GVD) or with VAVD. Due to the paucity of data on selected surgical populations, we sought to evaluate the early outcomes of patients undergoing isolated aortic valve replacement using VAVD or GVD. Methods Data on 521 patients between 09/2016 and 09/2022 were retrieved from our internal database. Patients were divided into two groups according to use VAVD or GVD. A propensity match analysis was performed to account for difference between the two groups. Results The propensity match provided two well balanced cohorts with 129 patients each. A minimally invasive access was used in 97% of the cases in VAVD group vs 98% in GVD group ( p = .68). Mean cardiopulmonary by-pass (CPB) time was 71 vs 73 min ( p = .74), respectively. There was no difference in lactates peak ( p = .19) and urine output during CPB ( p = .74). We registered two in-hospital deaths in VAVD cohort (1.6%) vs. no mortality in GVD group ( p = .5). Postoperative cerebral stroke occurred in 1 patient in GVD cohort vs. 0 in VAVD ( p = 1). Severe postoperative acute kidney injury complicated the course in 16 patients in GVD group and in 5 patients who had VAVD ( p = .012). VAVD was associated with a higher number of patients with elevated postoperative AST ( p = .07) and Troponin I ( p = .01) values. Conclusions The use of VAVD during isolated aortic valve replacement was not associated with increased risks of postoperative complications and in-hospital mortality with results that were at least similar to those registered in a matched cohort of patients operated on with GVD.

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Modified cardiopulmonary bypass with low priming volume for blood conservation in cardiac valve replacement surgery

Cited by 4 publications

References 26 publications

Exploring Perfusion Safety: A Review of Clinical and Non-Clinical Factors with Emphasis on Quality Improvement

Exploring Perfusion Safety: A Review of Clinical and Non-Clinical Factors with Emphasis on Quality Improvement

Con: Is Minimal Invasive Extracorporeal Circulation Superior to Conventional Cardiopulmonary Bypass in Cardiac Surgery?

Vacuum assisted and gravitational venous drainage in aortic valve surgery: A propensity-match study

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