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OBJECTIVE: We developed the original mini-semi-closed cardiopulmonary bypass (SC-CPB) for minimally invasive aortic valve replacement through the right mini-thoracotomy (MIAVR). The aim of this study is to evaluate advantage of the SC-CPB over conventional open cardiopulmonary bypass (O-CPB) in MIAVR.
METHODS: This original SC-CPB system included an air detector, air eliminator, air filters, and oxygenator in a compact manner in connection with a centrifugal pump. The venous line is directly connected to a centrifugal pump without open venous reservoir. A reservoir for only a vent and suckers was added on the circuit. We retrospectively reviewed and compared the outcomes of patients undergoing MIAVR using SC-CPB (n=15) with MIAVR using O-CPB (n=13) from March 2014 to December 2014. Demographic characteristics including age, body surface, hemoglobin level were similar in both groups.
RESULTS: CPB time was similar in both groups. There were significant difference in priming volume (SC-CPB vs O-CPB : 833 ml vs 1396 ml, p<0.001) and dilution rate (18% vs 27%, p<0.001). There was no hospital mortality in either group. Intraoperative blood transfusion rate of packed red cell was similar both group (SC-CPB vs O-CPB : 0% vs 15.3%, p=0.06), but postoperative blood transfusion rate (26.6% vs 69.2%, p<0.001) was lower in SC-CPB group. There was no hospital mortality in either group. The mean intubation time was shorter in SC-CPB group (8.9 hours vs 19.8 hours, p=0.034).
CONCLUSIONS: The use of SC-CPD with less hemodilution and blood-air interface provided significant reduction of blood transfusion and early postoperative recovery.