Comparing microvascular alterations during minimal extracorporeal circulation and conventional cardiopulmonary bypass in coronary artery bypass graft surgery: A prospective, randomized study

Abstract

Orthogonal polarization spectral imaging data reveal an impairment of microvascular perfusion during on-pump CABG. Changes in FCD indicate a faster recovery of the microvascular perfusion in MECC during the reperfusion period. Beneficial recovery of microvascular organ perfusion could partly explain the perioperative advantages reported for MECC.

The impact of haemodilution and bypass pump flow on cerebral oxygen desaturation during cardiopulmonary bypass - A comparison of two systems of cardiopulmonary bypass

“…Since the expert analysis of the factors that constitute 'optimal perfusion' by Murphy et al, 1 developments in this field have included descriptions of cerebral monitoring to determine the lower limit of cerebral autoregulation as a guide to optimal perfusion pressure, 2 advances in novel biomarkers to better understand the chronology of organ dysfunction after heart surgery 3 and new imaging techniques to study the effects of bypass perfusion parameters on microvascular blood flow. 4 Cerebral oximetry, using near-infrared spectroscopy, has also been heralded as an important monitor of the adequacy of blood flow and oxygenation, both to the brain 5 and to other major organs, 6 although the impact of this technology to alter postoperative neurological complications is limited. 7 In a recent attempt to determine the relative importance of pressure and flow on cerebral and systemic oxygen saturation, Moerman et al 8 manipulated perfusion pressure and flow during cardiopulmonary bypass (CPB).…”

Quantification of Operational Learning in Minimal Invasive Extracorporeal Circulation

“…Avoidance of blood transfusion as well as the biocompatible design of MiECC circuit with elimination of blood‐air interaction contributes to preservation of microvascular perfusion that ultimately leads to improved end‐organ protection during CPB . This could explain reduced duration of mechanical ventilation and need for ICU stay as well as the lower cumulative incidence of major adverse events observed in our study .…”

Available and emerging technologies for assessing intraoperative tissue perfusion during complex ventral hernia repair procedures

“…69,72,79 It has been investigated in imaging of both superficial tissues and numerous organs in humans and for intraoperative skin-flap assessment in animals. 69,72,79,80 Intraoperative use of OPS imaging has been studied for measurement of microvascular perfusion in patients undergoing coronary artery bypass graft surgery who were assigned to minimal extracorporeal circulation or conventional extracorporeal circulation during the surgical procedure. 80 Potential limitations to its use are that the imaging probe must be placed directly on the tissue surface, 69,72 that imaging high-velocity blood flow (eg, arterial vessels) depends on secondary image analysis, 69 and that signal penetration depth is limited to 3 mm (must be inserted into the body to image deeply embedded tissues).…”

“…69,72,79,80 Intraoperative use of OPS imaging has been studied for measurement of microvascular perfusion in patients undergoing coronary artery bypass graft surgery who were assigned to minimal extracorporeal circulation or conventional extracorporeal circulation during the surgical procedure. 80 Potential limitations to its use are that the imaging probe must be placed directly on the tissue surface, 69,72 that imaging high-velocity blood flow (eg, arterial vessels) depends on secondary image analysis, 69 and that signal penetration depth is limited to 3 mm (must be inserted into the body to image deeply embedded tissues). 79 indocyanine green imaging Indocyanine green (ICG) is an iodinated contrast dye that can be visualized under infrared or near-infrared light; it has been used extensively in intraoperative investigations of flap perfusion.…”