Document Detail


Clinical experience with assisted venous drainage cardiopulmonary bypass in elective cardiac reoperations.
MedLine Citation:
PMID:  18270133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Reoperative cardiac surgery is associated with substantial morbidity and mortality due to technical problems at sternal reentry, which can result in laceration of the right ventricle, innominate vein injury, or embolization from patent grafts. To minimize the risk associated with reentry, we adopted the method of assisted venous drainage in the cardiopulmonary bypass circuit with peripheral cannulation for cardiac reoperations. From March 1999 to May 2003, a series of 52 patients (38 males; mean age 48.7 years, range 4 months to 78 years) underwent cardiac reoperations performed with centrifugal pump venous-assisted cardiopulmonary bypass. EuroSCORE was 7.34 +/- 3.9 (range, 4-19). The reoperations were coronary artery bypass graft (25 patients), valve replacement/repair (18 patients), and complex pediatric procedures (11 patients). The studied adverse events were structural damage at reentry, mortality, blood loss, stroke, and hemolysis. Complications at sternotomy were damage to the innominate vein (1 patient) and aorta (1 patient) with blood loss of 625 and 225 mL, respectively. Four patients required intraaortic balloon pump or extracorporeal membrane oxygenation (n = 1) for hemodynamic support on weaning off cardiopulmonary bypass. Three patients died in the postoperative period. Our experience with centrifugal pump-assisted venous drainage in cardiac reoperations has shown excellent results, with reduced risk of damage to vital structures on sternal reentry. In cases in which structural damage did occur, blood loss was minimal.
Authors:
Brian Nyawo; P Botha; T Pillay; S C Clark; K Tocewicz; J Forty; J R L Hamilton; P Hill; A Hasan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  11     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-13     Completed Date:  2008-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E21-3     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle upon Tyne, United Kingdom. bcnyano@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cardiac Surgical Procedures / instrumentation*
Cardiopulmonary Bypass / methods*
Child
Child, Preschool
Female
Health Status Indicators
Humans
Infant
Male
Middle Aged
Reoperation*
Retrospective Studies
Risk Factors
Sternum / surgery
Suction / instrumentation,  methods*
Treatment Failure*
Treatment Outcome
Vacuum Curettage / instrumentation*,  methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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