TITLE

Total extrathoracic cardiopulmonary support with kinetic assisted venous drainage: experience in 50 patients

AUTHOR(S)
Toomasian, J.M.; McCarthy, J.P.
PUB. DATE
March 1998
SOURCE
Perfusion;1998, Vol. 13 Issue 2, p137
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Extrathoracic cardiopulmonary bypass is used in special situations when normal access to the right atrium and aorta is difficult or not practicable. Femero-femoral bypass using gravity drainage is effective for partial cardiopulmonary support, but cannot usually provide adequate venous drainage for full circulatory support. Kinetic assisted venous drainage (KAVD) is the process of applying a controlled suction on the venous line with a kinetic pump to augment venous drainage. KAVD has been used in 50 patients where femero-femoral bypass was selected as the mode of circulatory support. These cases included: redo-operations with significant sternal adhesions (15), minimally invasive port-access cardiac surgery (12), haemodynamic instability (10), left thoracotomy (10), and others (3). In 11 cases, a second venous catheter was added because of protocol. No appreciable increase in venous return occurred with the addition of a second drainage catheter. All patients were adequately supported and a 20-40% increase in venous return was observed once KAVD was implemented. A wide variety of different venous catheters have been used with KAVD. Optimal use relates to having a thin-walled catheter with multiple side holes, not exerting an excessive negative pressure with the pump and positioning the catheter tip at the right atrio-superior vena cava junction. Optimal catheter tip placement is enhanced by using transoesophageal echocardiography. KAVD is best regulated by measuring the siphon generated by the kinetic pump. When the inlet pressure is properly monitored and controlled, KAVD can provide adequate venous drainage to completely support the circulation on a single femoral venous cannula.
ACCESSION #
4089168

 

Related Articles

  • Retrieval of entrapped and knotted balloon-tipped catheters from the right heart. Voci, Gerardo; Gazek, Francisco A.; Burris, Alfredo O.; Zatuchini, Jacob; Voci, G; Gazek, F A; Burris, A C; Zatuchni, J // Annals of Internal Medicine;May80, Vol. 92 Issue 5, p638 

    Reports on two instances of successful retrieval of percutaneously inserted 7 French balloon-tipped catheters during repair of atriotomy for cardiopulmonary bypass. Details of how the catheters were inserted in the atrial wall and atrium of the patients; Penalties incurred during the operation;...

  • Treating pulmonary hypertension post cardiopulmonary bypass in pigs: milrinone vs. sildenafil analog. Urdaneta, F.; Lobato, E. B.; Beaver, T.; Muehlschlegel, J. D.; Kirby, D. S.; Klodell, C.; Sidi, A. // Perfusion;Mar2008, Vol. 23 Issue 2, p117 

    Procedures using cardiopulmonary bypass (CPB) and aortic cross-clamping are associated with a variable degree of ischemia/reperfusion of the lungs, leading to acute pulmonary hypertension (PHT). The purpose of this study was to compare the effects of the sildenafil analog (UK343-664), a...

  • New bench test for venous cannula performance assessment. Abdel-Sayed, S.; Favre, J.; Horisberger, J.; Taub, S.; Hayoz, D.; von Segesser, L. K. // Perfusion;Nov2007, Vol. 22 Issue 6, p411 

    Cannula design is of prime importance for venous drainage during cardiopulmonary bypass (CPB). To evaluate cannulas intended for CPB, an in vitro circuit was set up with silicone tubing between the test cannula encased in a movable preload reservoir and another static reservoir. The...

  • The hybrid approach for the surgical treatment of lone atrial fibrillation: One-year results employing a monopolar radiofrequency source. La Meir, Mark; Gelsomino, Sandro; Lorusso, Roberto; Luc�, Fabiana; Pison, Laurant; Parise, Orlando; Wellens, Francis; Gensini, Gian Franco; Maessen, Jos // Journal of Cardiothoracic Surgery;2012, Vol. 7 Issue 1, p71 

    Background: The hybrid technique combines a mono or bilateral epicardial approach with a percutaneous endocardial ablation in a single-step procedure. We present our early results with this technique employing a monopolar radiofrequency source through a right thoracoscopy in patients with lone...

  • Caval collapse during cardiopulmonary bypass: a reproducible bench model. Li, Liang; Abdel-Sayed, Saad; Berdajs, Denis; Tozzi, Piergiorgio; von Segesser, Ludwig K.; Ferrari, Enrico // European Journal of Cardio-Thoracic Surgery;Aug2014, Vol. 46 Issue 2, p306 

    OBJECTIVES During open heart surgery, so-called atrial chatter, a phenomenon due to right atria and/or caval collapse, is frequently observed. Collapse of the cava axis during cardiopulmonary bypass (CPB) limits venous drainage and may result downstream in reduced pump flow on (lack of volume)...

  • Extracorporeal membrane oxygenation, an anesthesiologist's perspective: Physiology and principles. Part 1. Chauhan, Sandeep; Subin, S. // Annals of Cardiac Anaesthesia;Sep2011, Vol. 14 Issue 3, p218 

    Extracorporeal membrane oxygenation (ECMO) is an adaptation of conventional cardiopulmonary bypass techniques to provide cardiopulmonary support. ECMO provides physiologic cardiopulmonary support to aid reversible aspects of the disease process and to allow recovery. ECMO does not provide...

  • Minimally invasive incision vs. sternotomy for valve repair. Sadovsky, Richard // American Family Physician;6/1/1998, Vol. 57 Issue 11, p2838 

    Presents information on the use of the median sternotomy, cardiopulmonary bypass and various degrees of systemic hypothermia in relation to classic surgery to repair or replace cardiac valves. Reference to the use of the minimally invasive or `key hole' surgery; Information on one patient...

  • RETROSPECTIVE ANALYSIS OF 286 PATIENTS REQUIRING CIRCULATORY SUPPORT WITH THE INTRAAORTIC BALLOON PUMP. Johnson, Mark D.; Holub, Daniel A.; Winston, Donald S.; Brewer, M. Alan; Hibbs, C. Wayne; Leachman, Catherine J.; Norman, John C. // Texas Heart Institute Journal;2005, Vol. 32 Issue 1, p428 

    Focuses on a study that examined the use of an intraaortic balloon pump by St. Luke's Episcopal Hospital-Texas Heart Institute in 1975 in post-cardiotomy patients who, because of a low output state, cannot be weaned from cardiopulmonary bypass despite pharmacologic intervention. Major...

  • A rat model of cardiopulmonary bypass with cardioplegic arrest and hemodynamic assessment by conductance catheter technique. Günzinger, Ralf; Wildhirt, Stephen; Schad, Hubert; Heimisch, Werner; Mendler, Nikolaus; Grammer, Joachim; Lange, Rüdiger; Bauernschmitt, Robert // Basic Research in Cardiology;Nov2007, Vol. 102 Issue 6, p508 

    Cardiopulmonary bypass (CPB) is known to induce systemic inflammation and cardiac dysfunction associated with a significant morbidity. Aim of the study was to develop an in vivo model of rat CPB with hypothermic cardiac arrest and the use of cardioplegia. The CPB circuit consisted of a venous...

Share

Read the Article

Courtesy of NEW JERSEY STATE LIBRARY

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics