A New Supportive Method for Aortic Aneurysm Surgery: Centrifugal Left Heart Bypass Combined with an Oxygenator and a Heat Exchanger

Abstract

A new supportive method of centrifugal left heart bypass with oxygenation was performed in 25 patients and compared with standard left heart bypass in 45 patients. Femoro-femoral bypass was selected in another 6 patients because of the presence of a left atrial adhesion. Intraoperative complications related to standard left heart bypass, hypoxia, hypothermia, and ventricular fibrillation, were eliminated by using this method. This supportive method maintained good hemodynamics and improved the surgical result of extended thoracoabdominal aortic replacement. Hospital deaths decreased from 6.7% to 3.2%.

The effect of left heart bypass on pulmonary blood flow and arterial oxygenation during one-lung ventilation in patients undergoing descending thoracic aortic surgery

“…In fact, some institutions incorporate an oxygenator into the LHB circuit at the cost of full heparinization in case severe hypoxemia occurs [8]. However, data on oxygenation with LHB during OLV are lacking.…”

Left Atrial to Femoral Artery Full Cardiopulmonary Bypass: A Novel Technique for Descending and Thoracoabdominal Aortic Surgery

“…Aomi et al also reported that their method showed an oxygenation advantage; patients in our CPB group also maintained superb oxygenation at all times. 4 We felt that directly draining and oxygenating desaturated blood from the "down" lung produced reliable and beneficial high oxygenation.…”

“…3 Aomi et al have previously reported a limited experience with DTAA repair using left heart bypass with a centrifugal pump, an oxygenator, and a heat exchanger. 4 The purpose of this article is to describe our initial experience performing DTAA replacement with a novel perfusion technique of left atrialfemoral artery (LA-FA) or distal aortic full CPB with an oxygenator, roller pump, and pump suckers.…”

Initial experience with the Nikkiso centrifugal pump during thoracoabdominal aortic aneurysm repair

“…Recent clinical data [1][2][3] support the use of distal aortic perfusion by bypass from the left atrium to the femoral artery or distal aorta as an adjunct to prevent spinal cord ischemia and subsequent neurologic deficits during graft replacement of extensive TAAAs (Crawford 4 extents I and II). Previously, we and others 3,[5][6][7][8] have reported using an indirect-drive centrifugal pump (Bio-Medicus BP-80, Eden Prairie, Minn.) for atriodistal bypass (ADB) during TAAA repair.…”