A retrospective comparative study of minimally invasive extracorporeal circulation versus conventional extracorporeal circulation in emergency coronary artery bypass surgery patients: a single surgeon analysis

Rufa, Magdalena; Schubel, Jens; Schaarschmidt, Jan; Tilişcan, Cătălin; Bauer, Adrian; Hausmann, Harald

doi:10.1093/icvts/ivv103

Cited by 7 publications

(10 citation statements)

References 23 publications

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“…1. аортокоронарное шунтирование [8][9][10]; 2. протезирование аортального клапана [8,[10][11][12][13][14][15][16][17][18]; 3. пластика митрального клапана [17]; 4. реконструктивная операция на грудной и брюшной аорте [17,18]; 5. имплантация вспомогательного устройства левого желудочка (LVAD) [19]; 6. Fast Track протокол [16,20].…”

Section: показания к использованию систем Mieccunclassified

“…Использование MiECC имеет преимущество у пациентов высокого риска: старшей возрастной группы и пожилых, с сахарным диабетом, предоперационной анемией, синдромом малого сердечного выброса, предполагаемым длительным ИК и другими категориями высокого риска [10,41,43,[52][53][54].…”

Section: преимущества системunclassified

“…При ретроспективном анализе экстренных операций внутрибольничная смертность ниже в группе с MiECC (113 пациентов) 4,4 против 6,8% (74 пациентов) в группе со стандартным искусственным кровообращением (p = 0,48) [10]. Однако следует отметить, что на 30-дневную летальность при экстренных операциях тип используемого ЭКК MiECC не оказывает влияния [42].…”

Section: биосовместимостьunclassified

“…По одним данным, различия в потребности в гемотрансфузиях при проведении ИК с обычным контуром и MiECC отсутствуют [51,63]. По другим данным, значительно меньше периоперационных трансфузий компонентов крови при использовании MiECC, в том числе и у пациентов старшей возрастной группы, у пациентов с исходной анемией и при выполнении экстренных операций [10,43,52,54].…”

Section: кровопотеря и трансфузииunclassified

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Haemostasis and minimally invasive extracorporeal circulation

Kornev¹,

Шелухин²

2019

PKiK

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Advances in extracorporeal circulation using a minimally invasive circuit have rapidly emerged, and the components and biocoatings of the minimally invasive extracorporeal circuit (MiECC) have improved. The application range of minimally invasive cardiopulmonary bypass has expanded, however the main indications for the use of MiECCs during cardiac surgery have not yet been systematized. To the best of our knowledge, no guidelines for anticoagulant therapy regimens during minimally invasive cardiopulmonary bypass exist, and its effect on blood loss and the activation of coagulation in the perioperative period remain unclear. The present review highlighted the components of the circuit and the practical aspects of using MiECC. We formulated indications for the use of minimally invasive circuits and classified biocompatible coatings used to reduce the contact activation of haemostasis. According to the literature, when performing cardiopulmonary bypass with MiECC, the physiological haemostatic balance is disturbed. The detected changes in plasma haemostasis do not allow drawing conclusions regarding the advantages of MiECC, despite its clinical benefits. Multicentre randomized trials that comply with the rules of the pre-analytical stage of haemostasis and use global tests (thrombin generation test, thrombodynamics test, etc.) are required. The available studies on the haemostatic system using MiECC are not adequate for determining whether MiECCs on a haemostatic system are recommendable. However, MiECCs allow physicians to get closer to the fast track cardiac surgery ideal.Received 7 October 2019. Revised 14 November 2019. Accepted 18 November 2019.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

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Section: показания к использованию систем Mieccunclassified

Section: преимущества системunclassified

Section: биосовместимостьunclassified

Section: кровопотеря и трансфузииunclassified

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Haemostasis and minimally invasive extracorporeal circulation

Kornev¹,

Шелухин²

2019

PKiK

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“…In order to minimize the adverse effects and improve endorgan protection minimal invasive extracorporeal circulation (MiECC) systems are successfully applied. Multiple studies have demonstrated the clinical benefits of MiECC systems, such as reduced hemodilution, reduced postoperative bleeding and transfusion requirements (3,8,9), preserved renal function (10,11), improved myocardial protection (12)(13)(14), attenuated inflammatory response (6,7), enhanced recovery of microvascular organ perfusion (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Background: Minimal invasive extracorporeal circulation (MiECC) circuits are an established alternative to conventional extracorporeal circulation (CECC). Based on the positive effects and improved perioperative outcomes of MiECC in adult cardiac surgery, this perfusion concept appears particularly attractive to pediatric cardiac surgery. So far, there are no reports on the clinical application of a MiECC system for corrective surgery in neonates and children. We report our initial experiences by using a MiECC system in pediatric cardiac surgery. Methods: A total of 38 pediatric patients underwent surgical interventions for a variety of congenital heart disease from March 2017 until August 2018 with a MiECC. Following the classification of MiECC circuits by the Minimal invasive Extra-Corporeal Technologies International Society (MiECTIS), type I and type III perfusion circuits were assembled depending on the planned intervention: type I for closed heart interventions and type III for open heart procedures. Primary outcome was conversion to CECC, secondary endpoints included major adverse cardiac or cerebrovascular events (MACCE). Results: MiECC perfusion was successfully performed in all patients (100%). Median patient age was 9.5 months (range, 0.2-176 months) with a median weight of 8.1 kg (range, 2.3-49 kg). For both MiECC types no system related technical complications were encountered. Beating heart procedures were performed in 23 cases (60%) at normothermia, while in 15 (40%) interventions cardioplegic cardiac arrest was induced at mild hypothermia. All patients had an uneventful perioperative course with no in-hospital mortality. MACCE did not occur during the hospitalization period. Conclusions: MiECC can be performed by using standard techniques for closed and open cardiac procedures for the correction of a variety of malformations in neonates and children with good results and uneventful postoperative course.

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