Abstract
Extracorporeal cardiopulmonary bypass (CPB) is the most common type of artificial circulatory support. The evolution of cardiac surgery is inextricably linked with the success of cardiopulmonary bypass. It facilitates surgery both on the surface and within the chambers of the heart providing the function of the heart and lungs, giving the blood momentum, and performing gas exchange, respectively. This allows the heart and lungs to be isolated from the patient’s systemic circulation. CPB was first used by John Gibbon on the May 6, 1953, to close an atrial septal defect in 18-year-old Cecilia Bavolek. Since then improvements in technology, management and understanding of CPB have significantly contributed to a reduction in patient morbidity and mortality. It has also enabled a shift toward an older more complicated patient population.
This chapter examines the cannulation sites necessary for CPB, their importance, and the options available. The in-depth description of the extracorporeal circuit focuses on the materials used and the properties of the various components. The non-physiological aspects of these components are highlighted and the importance of full patient anticoagulation for extracorporeal support is explained. The roles of the various associated CPB techniques are discussed, including myocardial protection during cross-clamping of the aorta and deep hypothermic arrest. The chapter also gives an insight into many of the acute and long-term complications of CPB and finally gives background information on the support devices allied with cardiac surgery, from intra-aortic balloon counterpulsation to the components of long-term extracorporeal membrane oxygenation (ECMO).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Edmunds LH. Adult Cardiac Surgery. New York: McGraw-Hill Education; Jan 1997. ISBN-10: 0070189633, ISBN-13: 978-0070189638.
Ward J. Oxygen delivery and demand. Surgery. 2006;24(10):354–60.
Gravlee GP, Davis RF, Utley JR, Kurusz M. Cardiopulmonary Bypass: Principles and Practice, 2nd ed. Philadelphia: Lippincott/Williams & Wilkins; May 2000.
Cardiopulmonary Bypass: Principles and practise, 2nd ed. Gravlee, GP., Lippincot/Williams&Wilkins, Philadelphia; 2000.
Shannon M. Anticoagulation. Surgery. 2007;25(4):150–4.
Kenneth G. Shann, Donald S. Likosky, John M. Murkin, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: A focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J Thorac Cardiovasc Surg. 2006;132:283–90.
Delbridge MS, Raftery A. Access for dialysis. Surgery. 2004;22(11):277–83.
Cardiovascular Physiology, 8th ed. Berne, RM. CV Mosby, St. Louis; 2000.
Casthely PA, Bregman D. Cardiopulmonary Bypass: Physiology, Related Complications, and Pharmacology. Mount Kisco, NY: Blackwell/Futura; November 1991. ISBN-10: 0879933968, ISBN-13: 978-0879933968.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer-Verlag London Limited
About this chapter
Cite this chapter
Mulholland, J. (2009). Artificial Circulatory Support. In: Hakim, N. (eds) Artificial Organs. New Techniques in Surgery Series, vol 4. Springer, London. https://doi.org/10.1007/978-1-84882-283-2_2
Download citation
DOI: https://doi.org/10.1007/978-1-84882-283-2_2
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-84882-281-8
Online ISBN: 978-1-84882-283-2
eBook Packages: MedicineMedicine (R0)