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Mechanical Effects of Cardiovascular Drugs and Devices
Published in Michel R. Labrosse, Cardiovascular Mechanics, 2018
The second category of short-term blood-contacting devices is external circuits through which blood is pumped and oxygenated. These include cardiopulmonary bypass (CPB), used during open heart surgery, and extracorporeal membrane oxygenation (ECMO), which provides longer-term support when evaluating treatment options for cardiopulmonary dysfunction. Cardiopulmonary bypass was developed in 1953 by Dr. John Gibbons at the Mayo Clinic to support the open-heart surgery needed for heart transplantation. In CPB, the patient’s heart is arrested and blood is diverted through an external circuit for gas exchange before being returned to the body. This provides a static bloodless field for the surgeon to repair the heart chamber or valves, replace valves or blood vessels, implant a left ventricular assist device (LVAD), remove clots from the pulmonary artery, and transplant a heart. The circuit is connected to the circulation under general anesthesia, with aortic cannulation for return of oxygenated blood and right atrial cannulation for gravity-assisted drainage of deoxygenated blood into the circuit. A perfusionist monitors and regulates blood flow and blood oxygenation to optimize tissue perfusion and protection. Most procedures strive to limit the time on CPB to 1 hour or less.
Treatment Devices
Published in Laurence J. Street, Introduction to Biomedical Engineering Technology, 2016
Heart–lung machines are operated by perfusionists, specially trained technologists who monitor and control system functions working in coordination with anesthetists, surgeons, and the rest of the surgical team (Figure 6.16).
Treatment Devices
Published in Laurence J. Street, Introduction to Biomedical Engineering Technology, 2023
Heart–lung machines are operated by perfusionists, specially trained technologists who monitor and control system functions working in coordination with anesthetists, surgeons, and the rest of the surgical team (Figure 6.16).
Managing large lead vegetations in transvenous lead extractions using a percutaneous aspiration technique
Published in Expert Review of Medical Devices, 2018
Christoph T. Starck, Jürgen Eulert-Grehn, Marian Kukucka, Dirk Eggert-Doktor, Thomas Dreizler, Benjamin Haupt, Volkmar Falk
Percutaneous aspiration of large lead vegetations prior and during transvenous lead extraction procedures is safe and effective.The reported aspiration procedure is minimal-invasive. It facilitates safe transvenous lead extraction in patients with large lead vegetations and avoids the need for open surgical extraction.Septic embolization of lead vegetations to the pulmonary circulation is eliminated or minimized.Since the aspiration procedure is based on an extracorporeal circuit the involvement of a cardiac surgeon and a perfusionist is mandatory, if the transvenous lead extraction procedure is performed by a cardiologist. The ideal operative environment is a hybrid operating room.The results of this initial experience and the effect on long-term outcomes need to be investigated in further larger and prospective studies.
Using machine learning to predict perfusionists’ critical decision-making during cardiac surgery
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2022
R. D. Dias, M. A. Zenati, G. Rance, Rithy Srey, D. Arney, L. Chen, R. Paleja, L. R. Kennedy-Metz, M. Gombolay
In the U.S. alone, it is estimated that more than 500,000 cardiac surgery operations are performed annually, with most of these procedures involving cardiopulmonary bypass (CPB) through a perfusion system managed by a perfusionist. (Epstein 2011; Alkhouli et al. 2020) Over the past 50 years, despite considerable improvements in patient safety, the incidence of preventable adverse events continues to be high in cardiac surgery, compared to other surgical specialities. (Cooley and Frazier 2000; Melly et al. 2018) Among the many factors that impact patient outcomes, intraoperative performance during CPB presents a strong association with both short- and long-term morbidity and mortality among patients undergoing cardiac surgery. (Salis et al. 2008; Chalmers et al. 2014)
Robotic totally endoscopic coronary artery bypass grafting: current status and future prospects
Published in Expert Review of Medical Devices, 2020
Johannes Bonatti, Stephanie Wallner, Bernhard Winkler, Martin Grabenwöger
Even though an interesting aspect development of telesurgery is limited, probably due to the fact that even if carried out in one room robotic CABG is a highly complex procedure which requires constant direct interaction with the table side team, anesthesia, and the perfusionist. Telementoring, however, has already been practiced and will be an important aspect to proctoring and training activities [31].