Modified cardiopulmonary bypass circuit for transcatheter aortic valve implantation and emergent cardiac surgery

Perfusion. 2024 Oct 17:2676591241293012. doi: 10.1177/02676591241293012. Online ahead of print.

Abstract

Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of severe aortic stenosis in high-risk patients, offering a minimally invasive alternative to open-heart surgery. However, complications such as hemodynamic instability may require mechanical circulatory support. In some cases, emergent cardiac surgery may be required, necessitating a swift transition to cardiopulmonary bypass (CPB). We modified the CPB circuit allowing for circulatory support and easy transition to CPB. No bleeding or vascular complications were observed. The modified CPB circuit minimizes hemodynamic disruptions and allows for postoperative ECMO support.

Keywords: cardiopulmonary bypass; closed cardiopulmonary bypass; emergent cardiac surgery; mechanical circulatory support; transcatheter aortic valve implantation; veno-arterial extracorporeal membrane oxygenation.