Department of Cardiovascular Surgery, 60521Ege University School of Medicine, Izmir, Turkey.
Vasc Endovascular Surg. 2022 Nov;56(8):737-742. doi: 10.1177/15385744221108049. Epub 2022 Jun 12.
The left heart bypass is currently the most frequent adjunct to provide distal aortic perfusion during aortic clamping. However, closed-circuits cannot respond to sudden hemodynamic fluctuations during aortic clamping which may lead to complications. In this report, we aim to give the technical aspects of reservoir-added centrifugal pump circuit system, its implementation and the clinical outcomes.
Between 2002 and 2020, the data of 35 patients underwent aortic aneurysm repair with the use of modified pump circuit were analyzed. The mean age was 53.4 years (range 24-73) and 91.4% of all was male. Preoperative demographics, intraoperative pump data and postoperative clinical outcomes were reported.
Thoracoabdominal incision was used in 22 patients (62.9%) and cerebrospinal fluid (CSF) drainage catheter was placed in 15 patients (42.9%). The left inferior pulmonary vein for outflow and the left femoral artery for inflow cannulation were used preferably. Median duration of pump support was 50 mins (13-121) in the cohort. The median transfusion of red packed cells was 2 units. Renal failure was observed in two patients and permanent paraplegia in one patient. Only one patient died in the elective group (1/34) and one patient in the emergent.
The reservoir-added centrifugal pump is an effective, practical, and flexible perfusion system which should be in the armamentarium of surgeons in order to solve difficult problems during open repair of descending and thoracoabdominal aortic aneurysms.
左心旁路目前是在主动脉夹闭时提供远端主动脉灌注的最常用辅助方法。然而，闭路系统无法应对主动脉夹闭期间突然出现的血流动力学波动，这可能导致并发症。在本报告中，我们旨在介绍储液器附加离心泵回路系统的技术方面、其实施情况以及临床结果。
2002 年至 2020 年，分析了 35 例接受改良泵回路辅助行主动脉瘤修复术患者的数据。平均年龄为 53.4 岁（范围 24-73），91.4%为男性。报告了术前人口统计学资料、术中泵数据和术后临床结果。
22 例（62.9%）采用胸腹联合切口，15 例（42.9%）放置脑脊液（CSF）引流导管。首选左下肺静脉作为流出道，左股动脉作为流入道进行插管。该队列中，泵辅助时间中位数为 50 分钟（13-121）。中位红细胞输注量为 2 单位。2 例患者出现肾功能衰竭，1 例患者出现永久性截瘫。择期组仅 1 例（1/34）和急诊组 1 例患者死亡。
储液器附加离心泵是一种有效、实用且灵活的灌注系统，外科医生应将其作为处理降主动脉和胸腹主动脉瘤开放修复期间出现的困难问题的手段之一。
