HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Piero Maria Mikus Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mikus, P. M. Articles by Galiè, N. Search for Related Content PubMed PubMed Citation Articles by Mikus, P. M. Articles by Galiè, N. Related Collections Cardiac - physiology Cardiac - other Extracorporeal circulation Great vessels

Eur J Cardiothorac Surg 2006;30:563-565
© 2006 Elsevier Science NL

How-to-do-it

Pulmonary endarterectomy: is there an alternative to profound hypothermia with cardiocirculatory arrest?

^a Heart and Lung Transplantation Program, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti n.9, Bologna, Italy
^b Department of Cardiac Surgery Anaesthesiology, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti n.9, Bologna, Italy
^c Department of Cardiology, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti n.9, Bologna, Italy

Received 28 October 2005; received in revised form 6 June 2006; accepted 26 June 2006.

^_* Corresponding author. Address: Via Battuti Verdi n.1, PC:47100 Forlì, Italy. Tel.: +39 03356223366; fax: +39 0516364751. (Email: dellamore76{at}libero.it).

The current surgical strategy for pulmonary endarterectomy (PEA) involves the use of extracorporeal circulation and hypothermic circulatory arrest (HCA). The aim of the present study was to test the feasibility of a different strategy of extracorporeal circulation, which could prevent bronchial back bleeding and allow a bloodless operating field, avoiding the risks associated with HCA in patients undergoing pulmonary endarterectomy. Between June 2004 and September 2005, eight patients underwent PEA without HCA. We introduced a double venting of the left heart sections, utilizing two cannulas placed in the left ventricle and atrium. Both vent cannulas are connected with vacuum device to prevent back-bleeding and left heart distension from the large amount of bronchial flow. We were able to perform pulmonary endarterectomy avoiding circulatory arrest and deep hypothermia without sacrificing the effectiveness of the procedure. The initial encouraging results have convinced us to apply systematically this technique in the cases operated in our center, even though further investigations are necessary to fully examine this technique.

Key Words: Great vessels disease • Cardiopulmonary bypass (CPB) • Endarterectomy • Pulmonary arteries • Pulmonary embolism

This article has been cited by other articles:

				P. M. Mikus, E. Mikus, S. Martin-Suarez, N. Galie, A. Manes, S. Pastore, and G. Arpesella Pulmonary endarterectomy: an alternative to circulatory arrest and deep hypothermia: mid-term results Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 159 - 163. [Abstract] [Full Text] [PDF]

				B. Thomson, S. S.L. Tsui, J. Dunning, A. Goodwin, A. Vuylsteke, R. Latimer, J. Pepke-Zaba, and D. P. Jenkins Pulmonary endarterectomy is possible and effective without the use of complete circulatory arrest--the UK experience in over 150 patients Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 157 - 163. [Abstract] [Full Text] [PDF]