PMID- 23814138
OWN - NLM
STAT- MEDLINE
DCOM- 20140502
LR  - 20211021
IS  - 1569-9285 (Electronic)
IS  - 1569-9293 (Print)
IS  - 1569-9285 (Linking)
VI  - 17
IP  - 4
DP  - 2013 Oct
TI  - Feasibility and safety of minimized cardiopulmonary bypass in major aortic 
      surgery.
PG  - 659-63
LID - 10.1093/icvts/ivt285 [doi]
AB  - OBJECTIVES: Conventional cardiopulmonary bypass causes haemodilution and is a 
      trigger of systemic inflammatory reactions, coagulopathy and organ failure. 
      Miniaturized cardiopulmonary bypass has been proposed as a way to reduce these 
      deleterious effects of conventional cardiopulmonary bypass and to promote a more 
      physiological state. The use of miniaturized cardiopulmonary bypass has been 
      reported in low-risk patients undergoing valve and coronary artery bypass graft 
      (CABG) surgery. However, little is known about its application in major aortic 
      surgery. METHODS: From February 2007 to September 2010, 49 patients underwent 
      major aortic surgery using the Hammersmith miniaturized cardiopulmonary bypass 
      (ECCO, Sorin). Data were extracted from medical records to characterize 
      preoperative comorbidities (EuroSCORE), perioperative complications and the use 
      of blood products. The same data were collected and described for 328 consecutive 
      patients having similar surgery with conventional cardiopulmonary bypass at the 
      Bristol Heart Institute, our twinned centre, during the same period. RESULTS: The 
      miniaturized cardiopulmonary bypass group had a median EuroSCORE of 8 
      [inter-quartile range (IQR): 5-11], 13% had preoperative renal dysfunction and 
      20% of operations were classified as emergency or salvage. Thirty-day mortalities 
      were 6.4; and 69, 67 and 74% had >/= 1 unit of red cells, fresh frozen plasma (FFP) 
      and platelets transfused, respectively. Eight percent of patients experienced a 
      renal complication, and 8% a neurological complication. The conventional 
      cardiopulmonary bypass group was similar, with a EuroSCORE of 8 (IQR: 6-10); 
      30-day mortalities were 9.4; and 68, 62 and 74% had >/= 1 unit of red cells, FFP 
      and platelets transfused, respectively. The proportions experiencing renal and 
      neurological complications were 14 and 5%. CONCLUSIONS: Our experience suggests 
      that miniaturized cardiopulmonary bypass is safe and feasible for use in major 
      aortic cardiac surgery. A randomized trial is needed to evaluate miniaturized 
      cardiopulmonary bypass formally.
FAU - Momin, Aziz U
AU  - Momin AU
AD  - Department of Cardiac Surgery, Imperial College London, Hammersmith Hospital, 
      London, UK.
FAU - Sharabiani, Mansour T A
AU  - Sharabiani MT
FAU - Kidher, Emadin
AU  - Kidher E
FAU - Najefi, Ali
AU  - Najefi A
FAU - Mulholland, John W
AU  - Mulholland JW
FAU - Reeves, Barnaby C
AU  - Reeves BC
FAU - Angelini, Gianni D
AU  - Angelini GD
FAU - Anderson, Jon R
AU  - Anderson JR
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130628
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aorta/*surgery
MH  - Blood Transfusion
MH  - Cardiopulmonary Bypass/adverse effects/instrumentation/*methods/mortality
MH  - Case-Control Studies
MH  - Equipment Design
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - London
MH  - Male
MH  - Middle Aged
MH  - Miniaturization
MH  - Postoperative Complications/mortality/therapy
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Vascular Surgical Procedures/adverse effects/mortality
PMC - PMC3781803
OTO - NOTNLM
OT  - Cardiopulmonary bypass
OT  - Heart surgery
OT  - Major aortic surgery
OT  - Miniaturized cardiopulmonary bypass
EDAT- 2013/07/03 06:00
MHDA- 2014/05/03 06:00
PMCR- 2014/10/01
CRDT- 2013/07/02 06:00
PHST- 2013/07/02 06:00 [entrez]
PHST- 2013/07/03 06:00 [pubmed]
PHST- 2014/05/03 06:00 [medline]
PHST- 2014/10/01 00:00 [pmc-release]
AID - ivt285 [pii]
AID - 10.1093/icvts/ivt285 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2013 Oct;17(4):659-63. doi: 
      10.1093/icvts/ivt285. Epub 2013 Jun 28.