TITLE

Beneficial effects of modern perfusion concepts in aortic valve and aortic root surgery

AUTHOR(S)
Kutschka, I.; Skorpil, J.; El Essawi, A.; Hajek, T.; Harringer, W.
PUB. DATE
January 2009
SOURCE
Perfusion;Jan2009, Vol. 24 Issue 1, p37
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Minimized perfusion circuits (MPC) were found to reduce side effects of standard extracorporeal circulation (ECC). We evaluated the safety and efficacy of the ROCsafe™ MPC for aortic valve and aortic root surgery. One hundred and seventy patients were randomized for surgery using either MPC [n = 85, 30 female/55 male, mean age: 69.8 ± 11.8 years; aortic valve replacement (AVR): n = 40; AVR + coronary artery bypass graft (CABG): n = 31; David operation: n = 3; aortic root replacement (ARR): n = 11] or ECC [n = 85, 29 female/56 male, mean age: 67.7 ± 9.5 years; AVR: n = 39; AVR+CABG: n = 35, David operation: n = 2; ARR: n = 9]. Neurological status, length of ICU stay, C-reactive protein (CRP), blood count, transfusion requirements and bleeding volume were analyzed. The MPC system provided ultrasound-controlled de-airing. A small roller pump and a flexible reservoir were used for left ventricular venting. As a control, we used a standard ECC with cardiotomy suction and hardshell reservoir. Cross-clamp time (MPC: 76.5 ± 29.5; ECC: 79.0 ± 34.0 min) and bypass time (MPC: 103.0 ± 37.9; ECC: 106.9 ± 44.9 min) were comparable between groups. Transfusion requirements (red blood cells: MPC: 1.5 ± 1.5 vs. ECC: 2.2 ± 2.1 units [p = 0.05], frozen plasma: MPC: 1.2 ± 1.8 vs. ECC: 1.9 ± 2.4 units [p = 0.03]), postoperative bleeding (MPC: 521 ± 283 vs. ECC: 615 ± 326 ml/24 h, p = 0.09) were lower using MPC. ICU stay was shorter with MPC (1.6 ± 1.6 days) compared to ECC (2.4 ± 2.8 days, p = 0.001). One stroke occurred in each group. The ROCsafe™ MPC provides safe circulatory support for a wide range of aortic valve surgeries. Transfusion requirements, postoperative bleeding and length of ICU stay were markedly reduced compared to standard extracorporeal perfusion.
ACCESSION #
43090931

 

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

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

Try another library?
Sign out of this library

Other Topics