Minimized closed circuit/centrifugal pump extracorporeal circulation: an effective aid in coronary bypass operations in Jehovah's Witnesses

Abstract

Surgical treatment of a Jehovah's Witnesses continues to be a great challenge in cardiac surgery. Different strategies are used to minimize the risk for early mortality, prolonged intensive care unit stay and hospitalization, resulting from anemia. Minimized closed circuit extracorporeal circulations have been shown to reduce adverse effects of conventional CPB. Two patients underwent urgent coronary revascularization for triple-vessel disease. The miniECC (Stöckert) is a phosphorylcholine-coated device which integrates the functions of oxygenation, filtration, and pumping in a compact manner with reduced total surface area and priming volume. After a well-tolerated operation the patients showed only minimal red blood cell damage (free hemoglobin 93 mg/l). Hematocrit levels decreasing perioperatively in both patients only moderately (32% and 30%). In these two instances using miniECC we showed a markedly reduced blood cell damage and myocardial trauma. Furthermore, we observed hematocrit levels being higher as compared to standard CABG patients, providing an optimized startpoint for an uneventful postoperative course. MiniECC can be routinely employed and reduces red blood cell damage. Therefore, it can be an effective aid in CABG operations in Jehovah's Witnesses.