In vitro and Clinical Results of Closed Circuit Cardiopulmonary Bypass in Corporation with a Novel Venous Reservoir

Tsutomu Mitsuie, Kazuya Inoue, Masaki Nakamura, Yusuke Seki, Tsuyoshi Ikuno, Yutaka Sakakibara, Kazunobu Nishimura

Takamatsu Red Cross Hospital, Takamatsu, Japan

Date, time and location: 2018.05.26 15:30, Press Hall, 2F

Abstract

Since cardiopulmonary bypass (CPB) operated in closed circuit system (CCS) does not contact to air, it reduce coagulation activity and inflammatory response. However, CCS is susceptible to change in internal pressure, and is affected by unexpected hemorrhage. A venous reservoir (JMS co., LTD) as a compliance chamber is devised to reduce risk of CCS. Objectives: We investigated efficacy of this venous reservoir (VR), using mock circulation, and clinical results in operation of on pump beating CABG (OPBC).Methods: VR is comprised of upper part housing (the blood side) and lower part housing (the isotonic solution side for adjustment), and it has a diaphragm between the housings. In vitro test using mock circulation, perfusion rate of the CPB was varied to 2, 3, and 4L/min with the same parameter of arterial and venous pressures. In each perfusion rate, amount of 50ml was slowly drained from the circuit for several seconds, and was returned. In clinical settings, 51 patients underwent OPBC using this closed CPB with VR. An average age was 70 years old, and 37% was emergency operation. Use of heparin was reduced to 1ml/kg. Total priming volume was 600ml.Results: In vitro test, with conditions of 3 and 4L/min, the PR reduced to 75% to 60%, and CVP significantly fell down to negative pressure without VR, while the PR and CVP was constant with VR. OPBC was successfully completed in all patients despite difficult clinical conditions such as bad aorta, unstable hemodynamics, An average number of graft was 3.2±0.7. One patient died due to non-cardiac reason. Graft patency was 98-100% in arterial conduits and 91% in saphenous vein.Conclusion: CCS with novel VR is safe and effective. This system can be applied in patients with OPBC and other type of simple cardiac operation.