Assisted venous drainage cardiopulmonary bypass in congenital heart surgery
Autor: | Jeffrey A. White, Jeffrey P. Jacobs, Jorge W. Ojito, Robert L. Hannan, Redmond P. Burke, Kagami Miyaji, Todd W McConaghey |
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Rok vydání: | 2001 |
Předmět: |
Heart Defects
Congenital Male Pulmonary and Respiratory Medicine medicine.medical_specialty Heart disease Risk Assessment Sensitivity and Specificity Statistics Nonparametric Veins law.invention Gravity drainage Postoperative Complications law Cardiopulmonary bypass medicine Humans Minimally Invasive Surgical Procedures Prospective Studies Probability Analysis of Variance Cardiopulmonary Bypass business.industry Hemodynamics Infant Newborn Infant Venous drainage medicine.disease Survival Analysis Surgery Treatment Outcome Anesthesia Drainage Female Heart repair Cardiology and Cardiovascular Medicine business Hospital stay Perfusion Venous return curve Follow-Up Studies |
Zdroj: | The Annals of Thoracic Surgery. 71:1267-1271 |
ISSN: | 0003-4975 |
Popis: | A novel active venous drainage perfusion circuit was designed to achieve effective venous return through small venous cannulas. The efficacy and safety of this new system was investigated and compared with a conventional gravity drainage system.Four hundred consecutive patients undergoing open heart repair of congenital heart lesions by one surgeon were studied. The first 200 patients were supported by gravity drainage and the next 200 patients were supported by assisted venous drainage. No patient in the time period was excluded from the study.The two groups did not differ significantly in weight, bypass time, or cross-clamp time. Priming volumes were less in the assisted group than in the gravity group (576+/-232 mL versus 693+/-221 mL, p0.001). Venous cannula size was smaller in the assisted group when compared with the gravity group (33.2F+/-7.4F versus 38.5F+/-7.1F, p0.001). There was a trend to lower operative mortality in the assisted drainage group (5 of 200, 2.5% versus 11 of 200, 5.5%; p = 0.10). Hospital stay and pulmonary, infectious, and neurologic complications were comparable in both groups. Cardiac complications were less common in the assisted group than in gravity group (22 of 200, 11% versus 38 of 200, 19%; p = 0.017). Hematologic complications were less common in the assisted group than the gravity group (6 of 200, 3% versus 19 of 200, 9.5%; p0.01).These findings suggest that assisted venous drainage is safe in congenital heart operations and facilitates the use of smaller venous cannulas. |
Databáze: | OpenAIRE |
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