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European Team Outlines Benefits Of Minimized Perfusion Circuit
"Can new technology impact outcomes?" asked Uwe Schönrock, CCP, Klinikum Braunschweig in Germany.
For the next 45 minutes, Mr. Schönrock shared his research and clinical results regarding minimized perfusion circuits to 100 perfusionists at the Optimizing Cardiac Surgery Symposium in Newport Beach, California on March 5, 2010.
Mr. Schönrock and his clinical team have used a minimized circuit — the ROCSafe Hybrid Perfusion System — in more than 2,500 cases. The Braunschweig Clinic documented the following clinical benefits:
- Superior de-airing compared to conventional open system1
- Reduced transfusion requirements in aortic valve surgery2,4
- Improved post-operative recovery3
- Reduced early inflammatory response and post-operative atrial fibrillation4
Mr. Schönrock is part of the progressive European clinical community which believes minimized perfusion "is not a new machine, it is a new philosophy."
The team's research determined these are the attributes of a minimized perfusion circuit:
- Minimized adverse effects of extracorporeal circulation
- Reduced priming volume and foreign surface area
- Increased biocompatibility
- Focused on air removal and safety
- A modular system allows usage for both CABG and valve procedures
Certain risks come with the rewards of using a minimized perfusion circuit, such as the learning curve, blood loss, limited venting and volume shifting, and negative pressure on the venous line.
Mr. Schönrock concluded his presentation by saying the ROCSafe Hybrid Perfusion System provides safe circulatory support for a wide range of cardiac procedures.
"Complex aortic valve operations are easy to handle with a minimized perfusion circuit," he stated. "Transfusion requirements are low in these patients. And in combination with warm blood cardioplegia, hemodilution is markedly reduced. That's the reason I'm a believer in these new technologies."
Like with any change in the operating room: close cooperation between the perfusionist, surgeon and anesthesiologist is required to achieve success. Mr. Schönrock credits his chief surgeon at the Braunschweig Clinic, Wolfgang Harringer, MD, who supported the development of this new philosophy.
"As clinicians, we cannot change the fact that they are having an operation," concludes Mr. Schönrock. "What we can change is the prime volume, surface coating and safety components."
- Kutschka, I, et al. A new minimized perfusion circuit provides highly effective ultrasound controlled deairing. Artificial Organs. 2007, 31(3): 215-220.
- Kutschka, I, et al. A new minimized perfusion circuit reduces transfusion requirements for Aortic valve surgery. EACTS/ESTS. September 9-13, 2006. Stockholm, Sweden.
- korpil, J, et al. Easy postoperative recovery — road to routine use of minimized perfusion circuit in open heart surgery. International Cardiovascular Surgical Symposium. March 3-10, 2007. Zürs, Switzerland.
- korpil, J, et al. A new minimized perfusion concept for aortic valve surgery reduces transfusion requirements and early inflammatory response. European Congress on Extracorporeal Circulation Technology. June 6-9, 2007. Kyiv, Ukraine.