Minimized Cardiopulmonary Bypass Techniques and Technologies

Minimized Cardiopulmonary Bypass Techniques and Technologies

by Terence Gourlay, Serdar Gunaydin

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Traditional cardiopulmonary bypass (CPB) techniques have suffered from a number of disadvantages including haemodilution, inflammation and post-operative bleeding. Minimised cardiopulmonary bypass techniques use developments in perfusion technology to significantly reduce foreign surface-blood interactions to make bypass simpler and safer. This important book reviews key developments and issues relating to this promising technology.

Part one covers the broad range of CPB pathophysiology, including anticoagulant protocols, the impact of CPB circuit surfaces, optimal haemodilution levels, and the important issue of CPB-induced systemic inflammatory response syndrome. Part two focuses on the issues of the new equipment developed for mini-CPB, optimal myocardial protection protocols and CPB perfusate options. Part three discusses clinical issues, including patient selection, coronary and valve surgery protocols and, among others, paediatric patients.

With its distinguished editors and international team of expert contributors, Minimized cardiopulmonary bypass techniques and technologies is a valuable reference for cardiac surgery teams and those researching this important technology.
  • Covers a broad range of cardiopulmonary bypass (CPB) pathophysiology, including anticoagulant protocols, the impact of CPB circuit surfaces and optimal haemodilution levels
  • Focuses on new equipment specially developed for minimized-CPB and myocardial protection protocols
  • Discusses clinical issues, including patient selection

Product Details

ISBN-13: 9780857096029
Publisher: Elsevier Science
Publication date: 04/19/2012
Series: Woodhead Publishing Series in Biomaterials
Sold by: Barnes & Noble
Format: NOOK Book
Pages: 272
File size: 3 MB

About the Author

Terence Gourlay is Professor of Medical Diagnostics in the Department of Biomedical Engineering at University of Strathclyde, UK.
Serdar Gunaydin is Professor in the Department of Cardiovascular Surgery, K. Kale University, Turkey. Both are internationally-renowned for their research in innovative CPB techniques.

Table of Contents

Contributor contact details


Chapter 1: Historical development of minimised cardiopulmonary bypass


1.1 Introduction and historical perspective

1.2 Cardiopulmonary bypass: from pioneering to refinement

1.3 Cardiopulmonary bypass: does size matter?

1.4 Conclusions

Chapter 2: Anticoagulation protocols for minimized cardiopulmonary bypass


2.1 Introduction: blood activation during cardiac surgery with cardiopulmonary bypass (CPB)

2.2 Anticoagulation during CPB: basic principles and historical notes

2.3 Heparin-bonded surfaces and other biocompatible treatments

2.4 Reduced systemic heparinization (RSH)

2.5 Contraindications

2.6 Future trends

Chapter 3: Minimized extracorporeal circulation: physiology and pathophysiology


3.1 Introduction: basic principles

3.2 The inflammatory cascade and biomarkers

3.3 Conclusions

Chapter 4: Blood–surface interface in miniaturised extracorporeal circulation systems


4.1 Introduction

4.2 Blood–surface contact in cardiopulmonary bypass (CPB)

4.3 Clinical benefits of miniaturised extracorporeal circulation systems

Chapter 5: Hemodilution: physiology and pathophysiology


5.1 Introduction

5.2 Basic physiology and pathophysiology of hemodilution

5.3 Microvascular alterations with hemodilution

5.4 Hemodilution and cardiopulmonary bypass (CPB)

5.5 Determinants of tissue oxygenation – functional capillary density (FCD)

5.6 Conclusions

Chapter 6: Inflammatory response and minimized cardiopulmonary bypass


6.1 Introduction

6.2 Cardiopulmonary bypass (CPB)-induced inflammatory cascade

6.3 Pharmacological antioxidants for CPB: impact on biochemical and clinical outcomes

6.4 Minimized CPB circuits

6.5 Acknowledgements

6.7 Appendix: abbreviations

Chapter 7: Design and principles of the minimized extracorporeal circuit


7.1 Introduction

7.2 Basic principles of minimized extracorporeal circulation

7.2 Evolution of minimized circuits

7.4 Minimized extracorporeal systems currently available

7.5 Surgical applications of minimized extracorporeal circulation

7.6 Controversies and challenges facing minimized cardiopulmonary bypass

7.7 Future trends in minimized cardiopulmonary bypass

Chapter 8: Cardiopulmonary bypass perfusate


8.1 Introduction

8.2 Crystalloid primes

8.3 Types of crystalloids and colloid agents used in prime

8.4 Pharmacological agents used in prime

8.5 Using prime in CPB procedures

8.6 Examples of prime combinations

8.7 Minimizing the use of prime

8.8 Conclusions

Chapter 9: Myocardial preservation techniques for mini-bypass


9.1 Introduction

9.2 Methods of myocardial protection

9.3 Myocardial protection in mini-bypass

9.4 Conclusion

Chapter 10: Minimised cardiopulmonary bypass: objectives and indications


10.1 Introduction: objectives of minimised cardiopulmonary bypass

10.2 Indications and patient selection

10.3 Future trends

Chapter 11: Coronary artery bypass grafting (CABG)


11.1 Introduction

11.2 History of coronary artery bypass grafting (CABG)

11.3 Patient selection (indications) for mini-invasive cardiopulmonary bypass

11.4 Conduits

11.5 Anastomoses techniques

11.6 Surgical management on mini-invasive cardiopulmonary bypass

11.7 Conclusions

Chapter 12: Valve surgery using minimized perfusion circuits


12.1 Introduction

12.2 Surgical and technical aspects

12.3 Blood management and patient treatment in valve surgery

12.4 Experience with closed-loop perfusion circuits in valve surgery

Chapter 13: Minimising cardiopulmonary bypass in children


13.1 Introduction

13.2 Challenges of cardiopulmonary bypass (CPB) in the congenital patient

13.3 Potential goals of mini-CPB

13.4 Mini-CPB and neurological outcome

13.5 Mini-CPB circuit design options in congenital heart surgery

13.6 Clinical trials

13.7 Alternative procedures to CPB

13.8 Conclusions

13.10 Appendix: abbreviations

Chapter 14: Comparison of minimized circulation with off-pump coronary artery bypass (OPCAB) grafting and conventional surgery


14.1 Introduction

14.2 Controversies and challenges facing off-pump coronary artery bypass (OPCAB) grafting

14.3 Studies comparing OPCAB with mini-cardiopulmonary bypass (mini-CPB) and mini-CPB assisted OPCAB

14.4 Future trends and competition between OPCAB and minimized cardiopulmonary bypass

Chapter 15: Minimally invasive cardiac surgery, port-access and robotic surgery


15.1 Introduction

15.2 Minimally invasive coronary artery bypass grafting

15.3 Minimally invasive valve surgery

15.4 Minimally invasive congenital surgery

15.5 Minimally invasive treatment of atrial fibrillation

15.6 Miscellaneous possibilities of minimally invasive surgery

15.7 Robotic surgery

15.8 Conclusions


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