Application of modified closed extracorporeal circulation circuits in the complex congenital heart disease

Meng Qing-qing; Xu Jian-jun; Zhou Cheng-bin; Zhang Xiao-hua; Chen Ping; Zhuang Jian

doi:10.13498/j.cnki.chin.j.ecc.2014.04.11

Abstract：[ Abstract]:Objective To summarize the application of modified closed extracorporeal circulation circuits in the complex con?genital heart disease. Methods From March 2009 to August 2014, modification of closed extracorporeal circulation ( ECC) circuits was performed in 14 cases of cardiac procedures for the complex congenital heart disease. The main lesions included hypoplastic left heart syndrome ( 4 cases) , anomalous origin of the left coronary artery from the pulmonary artery ( 3 cases) , coarctation with aorticarch hypoplasia ( 3 cases) , transposition of the great arteries with intact ventricular septum ( 3 cases) and tetralogy of Fallot with postopera?tive hypoxia ( 1 case) . The closed ECC circuit was made of heparin coating materials. A blood reservoir was installed in the venous line of the circuits after modification. The centrifugal pump in the circuits drove the blood from the blood reservoir to the oxygenator and then to the whole body. If extracorporeal membrane oxygenation ( ECMO) support needed, the centrifugal pump was directly connected to the venous line without blood reservoir. Results The average ECC time was (164.4±71.9) min and the average aortic clamping time was (71.4±21.9) min. Six patients underwent deep hypothermia circulatory arrest. Twelve cases weaned off the ECC and 2 cases were transported into ECMO support. The total mortality rate was 21.4%. Conclusion The centrifugal pump, heparin coated circuits and oxygenator in the closed ECC circuits could be used in cardiac procedures for the complex congenital heart disease. The modification technology for the circuits is feasible and simplified for ECMO support postoperatively.