Vacuum Assisted Cardiopulmonary Bypass in Minimally Invasive Cardiac Surgery: Its Feasibility and Effects on Hemolysis

Shin, Hankei; Yozu, Ryohei; Maehara, Tadaaki; Matayoshi, Toru; Morita, Masanori; Kawai, Yoko; Yamada, Tatsuya; Kawada, Shiaki

doi:10.1046/j.1525-1594.2000.06587.x

Cited by 26 publications

(32 citation statements)

References 9 publications

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“…These include use of cell salvage (which in our study was not associated with increased risk of infection), use of small priming volume cardiopulmonary bypass circuits, minimizing hemodilution by crystalloid fluids, use of vacuum-assisted venous return (36, 37) with rapid autologous priming (38), increase in hematocrit by modified ultrafiltration (39), elevation of preoperative hematocrit in elective cases by iron and B-complex vitamin administration, and, possibly, the selective use of erythropoetin, although not approved by the FDA for this indication (40, 41). In addition, attention to intraoperative hemostasis, establishment of protocols for transfusion and reoperation for bleeding, use of anti-fibrinolytics, and a tolerance for mild-to-moderate anemia are reasonable means to reduce use of a scarce resource (35).…”

Section: Commentmentioning

confidence: 80%

Blood Transfusion and Infection After Cardiac Surgery

Horvath

Acker

Chang

et al. 2013

The Annals of Thoracic Surgery

273

182

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Cardiac surgery is the largest consumer of blood products in medicine; although believed life saving, transfusion carries substantial adverse risks. This study characterizes the relationship between transfusion and risk of major infection after cardiac surgery. 5,158 adults were prospectively enrolled to assess infections after cardiac surgery. The most common procedures were isolated coronary artery bypass grafting (31%) and isolated valve surgery (30%); 19% were reoperations. Infections were adjudicated by independent infectious disease experts. Multivariable Cox modeling was used to assess the independent effect of blood and platelet transfusions on major infections within 60±5 days of surgery. Red blood cells (RBCs) and platelets were transfused in 48% and 31% of patients, respectively. Each RBC unit transfused was associated with a 29% increase in crude risk of major infection (P<0.001). Among RBC recipients, the most common infections were pneumonia (3.6%) and bloodstream infections (2%). Risk factors for infection included postoperative RBC units transfused, longer duration of surgery, and transplant or ventricular assist device implantation, in addition to chronic obstructive pulmonary disease, heart failure, and elevated preoperative creatinine. Platelet transfusion decreased the risk of infection (P=.02). Greater attention to management practices that limit RBC use, including cell salvage, small priming volumes, vacuum-assisted venous return with rapid autologous priming, and ultrafiltration, and pre- and intraoperative measures to elevate hematocrit could potentially reduce occurrence of major postoperative infections.

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Section: Commentmentioning

confidence: 80%

Blood Transfusion and Infection After Cardiac Surgery

Horvath

Acker

Chang

et al. 2013

The Annals of Thoracic Surgery

273

182

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“…Thanks to technological advancements that now allow for the development of minimally invasive cardiac surgery, where the technique of VAVD has been essential safely and effectively [7][8][9][10], is also increasing the number of studies on the use of this technique in cardiac surgery of access and traditional cannulation. In this sense, these authors cite several benefits gained by the substitution of conventional drainage, which is based on sinfonagem and gravity drainage by using the active vacuum [11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Drenagem venosa assistida a vácuo na circulação extracorpórea e necessidade de hemotransfusão: experiência de serviço

Chalegre¹,

Salerno

Salerno³

et al. 2011

Rev Bras Cir Cardiovasc

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“…Shin et al 16 showed that this approach does not appreciably increase haemolysis compared with traditional CPB.…”

Section: Flow and Venous Drainagementioning

confidence: 99%

Open and closed chest extrathoracic cannulation for cardiopulmonary bypass and extracorporeal life support: methods, indications, and outcomes

Field

Al-Alao

Mediratta

et al. 2006

Postgraduate Medical Journal

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Extrathoracic cannulation to establish cardiopulmonary bypass has been widely applied in recent years and includes: (a) repeat surgery, (b) minimally invasive surgery, and (c) cases with diseased vessels such as porcelain, aneurysmal, and dissecting aorta. In addition, the success and relative ease of peripheral cannulation, among other technological advances, has permitted the development of closed chest extracorporeal life support, in the form of cardiopulmonary support and extracorporeal membrane oxygenation. With this development have come applications for cardiopulmonary bypass based support outside the traditional cardiac theatre setting, including emergency circulatory support for patients in cardiogenic shock and respiratory support for patients with severely impaired gas exchange. This review summarises the approach to extrathoracic cannulation for the generalist.

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Vacuum Assisted Cardiopulmonary Bypass in Minimally Invasive Cardiac Surgery: Its Feasibility and Effects on Hemolysis

Cited by 26 publications

References 9 publications

Blood Transfusion and Infection After Cardiac Surgery

Blood Transfusion and Infection After Cardiac Surgery

Drenagem venosa assistida a vácuo na circulação extracorpórea e necessidade de hemotransfusão: experiência de serviço

Open and closed chest extrathoracic cannulation for cardiopulmonary bypass and extracorporeal life support: methods, indications, and outcomes

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