scholarly journals Initial experiences with a centrifugal-pump based minimal invasive extracorporeal circulation system in pediatric congenital cardiac surgery

2019 ◽  
Vol 11 (S10) ◽  
pp. S1446-S1452
Author(s):  
Alexander Kadner ◽  
Paul Philipp Heinisch ◽  
Maris Bartkevics ◽  
Serena Wyss ◽  
Hans-Joerg Jenni ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Centrifugal Pump ◽  
Extracorporeal Circulation ◽  
Minimal Invasive ◽  
Circulation System ◽  
Congenital Cardiac Surgery

Minimal invasive extracorporeal circulation preserves platelet function after cardiac surgery: a prospective observational study

Perfusion ◽  
2019 ◽  
Vol 35 (2) ◽  
pp. 138-144
Author(s):  
Helena Argiriadou ◽  
Polychronis Antonitsis ◽  
Anna Gkiouliava ◽  
Evangelia Papapostolou ◽  
Apostolos Deliopoulos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Correlation Coefficient ◽  
Platelet Function ◽  
Extracorporeal Circulation ◽  
Point Of Care ◽  
Postoperative Bleeding ◽  
Minimal Invasive ◽  
Elective Cardiac Surgery ◽  
Impedance Aggregometry

Introduction: Cardiac surgery on conventional cardiopulmonary bypass induces a combination of thrombocytopenia and platelet dysfunction which is strongly related to postoperative bleeding. Minimal invasive extracorporeal circulation has been shown to preserve coagulation integrity, though effect on platelet function remains unclear. We aimed to prospectively investigate perioperative platelet function in a series of patients undergoing cardiac surgery on minimal invasive extracorporeal circulation using point-of-care testing. Methods: A total of 57 patients undergoing elective cardiac surgery on minimal invasive extracorporeal circulation were prospectively recruited. Anticoagulation strategy was based on individualized heparin management and heparin level–guided protamine titration performed in all patients with a specialized point-of-care device (Hemostasis Management System – HMS Plus; Medtronic, Minneapolis, MN, USA). Platelet function was evaluated with impedance aggregometry using the ROTEM platelet (TEM International GmbH, Munich, Germany). ADPtest and TRAPtest values were assessed before surgery and after cardiopulmonary bypass. Results: ADPtest value was preserved during surgery on minimal invasive extracorporeal circulation (58.2 ± 20 U vs. 53.6 ± 21 U; p = 0.1), while TRAPtest was found significantly increased (90 ± 27 U vs. 103 ± 38 U; p = 0.03). Postoperative ADPtest and TRAPtest values were inversely related to postoperative bleeding (correlation coefficient: −0.29; p = 0.03 for ADPtest and correlation coefficient: −0.28; p = 0.04 for TRAPtest). The preoperative use of P2Y12 inhibitors was identified as the only independent predictor of a low postoperative ADPtest value (OR = 15.3; p = 0.02). Conclusion: Cardiac surgery on minimal invasive extracorporeal circulation is a platelet preservation strategy, which contributes to the beneficial effect of minimal invasive extracorporeal circulation in coagulation integrity.

Effect of a miniaturized extracorporeal circulation (MECC™System) on liver function

Perfusion ◽  
2007 ◽  
Vol 22 (4) ◽  
pp. 245-250 ◽  
Author(s):  
Christopher Prasser ◽  
Mohamed Abbady ◽  
Cornelius Keyl ◽  
Andreas Liebold ◽  
Magda Tenderich ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Liver Function ◽  
Extracorporeal Circulation ◽  
Bolus Injection ◽  
Circulation System ◽  
Percentage Increase ◽  
Plasma Disappearance Rate ◽  
Double Indicator Dilution ◽  
Extracorporeal Circuits ◽  
Induction Of Anaesthesia

Objective: To evaluate the effect of a miniaturized extracorporeal circulation system (MECC™System) compared to conventional extracorporeal circulation (ECC) regarding liver function in cardiac surgical patients. Methods: Double indicator dilution measurements were achieved by bolus injection of indocyanine green (ICG) for assessment of cardiac index (CI) and plasma disappearance rate of ICG (PDRig). Measurements were simultaneously performed preoperatively after induction of anaesthesia (T1), following admission on the ICU (T2) and 6 h postoperatively (T3). Results: CI and PDRig were markedly increased after cardiac surgery without significant differences between groups. The percentage increase in CI was significantly correlated to the percentage increase in PDRig in both groups. Conclusion: Liver function improved after cardiac surgery in both groups of patients, which may partly be explained by an increase in CI under mild inotrope support. Differences between the extracorporeal circuits with respect to PDRig appear to be minimal in a group of patients without pre-existing liver injury. Perfusion (2007) 22, 245—250.

scholarly journals Effects of pulsatile minimal invasive extracorporeal circulation on fibrinolysis and organ protection in adult cardiac surgery—a prospective randomized trial

2019 ◽  
Vol 11 (S10) ◽  
pp. S1453-S1463
Author(s):  
Angelika Graßler ◽  
Robert Bauernschmitt ◽  
Irene Guthoff ◽  
Andreas Kunert ◽  
Markus Hoenicka ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Randomized Trial ◽  
Extracorporeal Circulation ◽  
Minimal Invasive ◽  
Prospective Randomized Trial ◽  
Organ Protection ◽  
Adult Cardiac Surgery

Minimal invasive extracorporeal circulation preserves coagulation integrity

Perfusion ◽  
2021 ◽  
pp. 026765912199854
Author(s):  
Helena Argiriadou ◽  
Polychronis Antonitsis ◽  
Anna Gkiouliava ◽  
Evangelia Papapostolou ◽  
Apostolos Deliopoulos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Point Of Care ◽  
Postoperative Bleeding ◽  
Significant Proportion ◽  
Coagulation Factors ◽  
Minimal Invasive ◽  
Rotational Thromboelastometry ◽  
Elective Cardiac Surgery ◽  
Transfusion Requirements

Introduction: Coagulopathy after cardiac surgery is a serious multifactorial complication that results in postoperative bleeding requiring transfusion of red blood cells and procoagulant products. Use of cardiopulmonary bypass represents the major contributing factor affecting coagulation. We sought to prospectively investigate the effect of contemporary minimal invasive extracorporeal circulation (MiECC) on coagulation parameters using point-of-care (POC) rotational thromboelastometry and the relation to postoperative bleeding. Methods: Patients undergoing elective cardiac surgery on MiECC were prospectively recruited. Anticoagulation strategy was based on individualized heparin management and heparin level-guided protamine titration. Rotational thromboelastometry testing was performed before induction of anesthesia and after aortic cross-clamp release. A strict POC-guided transfusion protocol was implemented. The primary endpoint was the assessment of viscoelastic properties of the coagulating blood at the end of surgery compared to preoperative values and the relation to postoperative bleeding and 24-hour transfusion requirements. Results: Fifty patients were included in the study with a significant proportion having complex surgery. Thirteen patients (26%) required blood transfusion (mean rate: 0.5 ± 1 units per patient), 5/50 (10%) received coagulation factors while no patient received fresh frozen plasma, platelets or fibrinogen. Thromboelastometry analysis showed that the major derangement was CT EXTEM > 100 seconds in 28/50 (56%) and A10 EXTEM < 40 mm in one (2%) patient without clinical significance. Platelet function was preserved throughout surgery. A10-FIBTEM was found predictive of postoperative bleeding at 12 hours. Conclusions: MiECC preserves clot quality throughout surgery acting in both key determinants of clot strength; fibrinogen and platelets. This is clinically translated into minimal postoperative bleeding and restricted use of blood products and coagulation factors.

scholarly journals The “benefits” of the mini-extracorporeal circulation in the minimal invasive cardiac surgery era

2014 ◽  
Vol 63 (6) ◽  
pp. 391-396 ◽  
Author(s):  
Nikolaos G. Baikoussis ◽  
Nikolaos A. Papakonstantinou ◽  
Efstratios Apostolakis
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Minimal Invasive ◽  
Minimal Invasive Cardiac Surgery
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