Terumo Cardiovascular Systems

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optimizing cardiac surgery

SIRS

Systemic inflammatory response syndrome (SIRS) results in generalized edema and dysfunction of critical organ systems. It can be alleviated by reducing harmful exposure of blood and tissue to air and/or non-biological surfaces in the extracorporeal circuit.

Information provided on this website is not intended to make claims that the products are safe and effective for any use other than those explicitly described in the Instructions for Use. Clinicians should refer to the Instructions for Use or Owner's Manuals for complete information on the intended use of any product mentioned in this website.

CASE STUDY: Bloodless Cardiac Surgery is a Team Sport
Ninety percent of patients weighing over 25 kilos have surgery without receiving blood at The Heart Center at Nationwide Children's Hospital in Columbus, Ohio. Read about its blood management program.
SYNOPSIS: European Team Outlines Benefits Of Minimized Perfusion Circuit
At the Optimizing Cardiac Surgery Symposium on March 5, 2010, Uwe Schönrock, CCP, Klinikum Braunschweig, shared the clinical benefits of his team's use of the ROCSafe™ Hybrid Perfusion System in 2,500 cases.
STUDY: Pediatric Hospital Uses New Technology to Remove Gaseous Microemboli and Reduce Blood Usage
Nationwide Children's Hospital evaluated the CAPIOX FX Oxygenator with an integrated arterial filter and found it significantly reduced prime volume and GME.
NEW! CDROM: The Inflammatory Response to CPB – Continued Clinical Challenges and Technological Opportunities
Terence Gourlay, PhD, shares blood management studies from the University of Strathclyde in Scotland during the Optimizing Cardiac Surgery Symposia in Newport Beach, California in February 2010.
NEW! CDROM: Controlling SIRS: Can new technology impact outcomes?
Uwe Schonrock, CCP, discusses the use and results of a minimized circuit at Braunschweig Klinikum in Germany during his Optimizing Cardiac Surgery Symposia presentation in Newport Beach, California in February 2010.
ABSTRACT: Improving Cardiac Surgery Outcomes: Leukocyte Filtration
Amit Patel, MD, presents his outcome data on 2,000 patients undergoing cardiac surgery with leukocyte filtration at the July 2004 Hammersmith Meeting.
CDROM: Non-Pharmacologic Therapeutic Strategies for Reducing Complications of Cardiopulmonary Bypass
Serdar Gunaydin, MD, PhD, presents clinically significant results using XCoating™ and leukocyte filtration for high-risk patients at the May 2006 Optimizing Cardiac Surgery Symposium.
CDROM: Circuit Evolution and Patient Benefits
Ben Komorowski, CCP, shares the eight year evolution of the changes in his perfusion circuit at the Orlando 2006 Optimizing Cardiac Surgery Symposium.
CDROM: From Science to Clinical Practice: A Synergistic Approach to Reducing Blood Loss and the Inflammatory Response
David Fallen, CCP, discuss non-pharmacologic approaches to reducing bleeding and SIRS at the Optimizing Cardiac Surgery Symposium in May 2006.
CDROM: Air Emboli: Source and Impact
David Stump, PhD, offers strategies to reduce the number of cerebral emboli at the March 2007 San Diego Optimizing Cardiac Surgery Symposium.
STUDY: Aprotinin and Leukocyte Filtration Reduces Post-Operative Atrial Fibrillation
Albert O-Yurvati, DO, presented a study at the July 2006 Hammersmith Meeting showing the impact of leukocyte filtration and aprotinin on reducing post-op Afib.
CDROM: Leukocyte Filtration and the Multiple Modality Approach of Anti-Inflammatory Strategy
Order a complimentary CDROM of the New Orleans Optimizing Cardiac Surgery Symposium (April 2005) to watch Steve Sutton CCP's presentation on the benefits of continuous leukocyte filtration.
SYNOPSIS: Reducing a patient's exposure to banked blood . . . priceless.
At the San Diego Optimizing Cardiac Surgery Symposium (February 2008), David Fitzgerald, CCP, Joseph Basha, CCP, Jim Patterson, CCP, and Brad Kulat, CCP presented cost savings resulting from blood management programs.
CDROM: Benefits of Leukocyte Filtration for CPB
Amit Patel, MD, presents leukocyte filtration strategies at the Orlando 2006 Optimizing Cardiac Surgery Symposium.
CDROM: Leukocyte Filtration: Can this Technology Improve Outcomes in Cardiac Surgery?
Albert O-Yurvati, DO, presents his work with leukocyte filtration at the 2006 Optimizing Cardiac Surgery Symposium.
CDROM: Benefits, Features and Results of Reduced Prime Circuits
Order a complimentary CDROM of the New Orleans 2005 Optimizing Cardiac Surgery Symposium (April 2005) to watch David Fallen, CCP's presentation on the use of reduced prime circuits.
ABSTRACT: A New Poly-2-Methoxyethylacrylate-Coated CPB Circuit Possesses Superior Platelet Preservation and Inflammatory Suppression Efficacy. Annals of Thoracic Surgery. 2004; 77:1678-1683 Ikuta T, et al.
This study compares the biocompatibility of PMEA-coated circuits to heparin-coated and non-coated circuits, focusing on platelet preservation and systemic inflammatory response.
ABSTRACT: Investigation of Blood Compatibility of PMEA-Coated Extracorporeal Circuits. Journal of Bioactive and Compatible Polymers, Vol 17, Sept 2002. Kocakulak M, et al.
In a study comparing PMEA-coated and uncoated oxygenators, the authors found greater retention of clotting factors and platelets and less post-op hemorrhaging when using PMEA-coated oxygenators.
ABSTRACT: Evaluation of a New Condensed Extracorporeal Circuit for Cardiac Surgery: A Prospective Randomized Clinical Pilot Study. Perfusion 2005; vol. 20, 91-99. Fransen, et al.
The authors noted an improvement in biocompatibility in a reduced prime circuit with X Coating over a traditional circuit with heparin-coating.
ABSTRACT: Emerging Technologies in Biocompatible Surface Modifying Additives: Quest for Physiologic CPB. Cardiovascular and Hematological Agents. 2004; Vol. 2:No 4. Gunaydin S, et al.
The authors compare surface coatings, including X Coating, in 155 CPB cases for chemical composition, biomaterial evaluation and clinical efficacy.
ABSTRACT: The CAPIOX RX05 Oxygenator: Pediatric Clinical Observations. Perfusion. 2003;18, 321-323, Tinius, et al.
The authors provide clinical observations on the use of the CAPIOX® BABY RX™ Oxygenator and reducing prime volume in neonate circuits.
ABSTRACT: Effects of New Polymer-Coated Extracorporeal Circuits on Biocompatibility During Cardiopulmonary Bypass. Artificial Organs, Volume 24, No 7, 2000. Saito, et al.
This study compares X Coating™ to heparin coating in reducing the release of bradykinin and leukocyte activation during CPB.
ABSTRACT: Biocompatibility of Poly (2-methoxyethylacrylate) Coating for Cardiopulmonary Bypass. Annals Thoracic Cardiovascular Surgery, 2003, Volume 9, No 1. Noguchi, et al.
The authors compare the biocompatibility of PMEA-coated and heparin-coated circuits by measuring several inflammatory markers. Results indicate PMEA-coated circuits are as biocompatible as heparin coated circuits.
ABSTRACT: How Effective are Cardiopulmonary Bypass Circuits at Removing Gaseous Microemboli? JECT:2002;34:34-39. Stump D, et al.
This paper demonstrates how the quantity of venous air passed through a circuit differs by circuit design and manufacturer under both VAVD and gravity conditions.
ABSTRACT: X Coating: A New Biopassive Polymer Coating. Canadian Perfusion Canadienne, Volume 11, No 2, June 2001. Schiel, et al.
This paper explains the mechanism and benefits of X Coating.
ABSTRACT: Inflammatory Response to Cardiac Surgery and Strategies to Overcome It. Annals of Cardiac Anaesthesia 2004;7:113-128. Kapoor, et al.
A review of the inflammatory response including: mediators of the response, role of surgical stress, the pathogenesis of organ damage and strategies to limit or overcome the response.
ABSTRACT: Non-Pharmacologic Therapeutic Strategies for Reducing Complications of Cardiopulmonary Bypass. Filtration 2005; 1(2):95-106. Gunaydin S, et al.
This study of 225 patients undergoing CPB concludes that the use of circuits with leukocyte filtration and X Coatingâ?¢ provides clinically significant benefits for high risk patients.
ABSTRACT: Summary of Select Studies on Air Bubble Removal
Several studies indicate that gaseous microemboli in the extracorporeal circuit is a clinical concern; some demonstrate an association between GME and neurological damage or other organ failure after cardiac surgery.
ABSTRACT: Beneficial Effects of Modern Perfusion Concepts in Aortic Valve and Aortic Root Surgery. Perfusion 2009;24: 37-44, Kutschka, et al.
In this 170-patient study, the use of the ROCSafe™ Hybrid Perfusion System was found to reduce side effects of standard extracorporeal circulation.
ABSTRACT: A New Minimized Perfusion Circuit Provides Highly Effective Ultrasound Controlled Deairing. Artificial Organs. 2007 Mar; 31(3):215-220, Kutschka, et al.
This study compared a ROCSafe™ Hybrid Perfusion System to conventional perfusion circuit and results indicated that active venous deairing was significantly reduced compared to passive deairing on a conventional circuit.
ABSTRACT: 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 Surg2006;132:283-290. Shann KG, et al.
The authors, members of the International Consortium for Evidence-Based Perfusion, offer their first publication of evidence and recommendations on the practice of managing patients on CPB.
ABSTRACT: Intraoperative Treatment Strategy to Reduce the Incidence of Post-Cardiopulmonary Bypass Atrial Fibrillation. Perfusion 2002; V 17. O-Yurvati A.
In this study, the authors demonstrate a 72% reduction in the incidence of post-op atrial fibrillation in patients who receive leukocyte filtration and aprotinin, resulting in $8,725 savings per patient.
ABSTRACT: Leukocyte Filtration and Aprotinin: Synergistic Anti-Inflammatory Protection. Perfusion 2004; Volume 19. O-Yurvati A.
In this follow-up study, Albert O-Yurvati, DO, compares the effects of leukocyte filtration combined with aprotinin versus aprotinin alone to reduce post-operative atrial fibrillation in patients undergoing CPB.
ABSTRACT: Aprotinin for Primary Coronary Artery Bypass Grafting: A Multicenter Trial of Three Dose Regimens. Annals of Thoracic Surgery, 1996;62:1659-1668. Lemmer, et al.
The study compares high and low dose Aprotinin to low dose in patients undergoing coronary artery bypass grafting.
ABSTRACT: Evaluation of Leukocyte-Depleted Terminal Blood Cardioplegia Solution in Patients Undergoing Elective and Emergency Coronary Artery Bypass Grafting. Journal of Thoracic and Cardiovascular Surgery. 1994;108, 6:1125-3. Sawa, et al.
The authors demonstrate leukocyte-depleted terminal blood cardioplegia provides superior myocardial protective effects in patients undergoing aortic cross-clamping for more than 120 minutes.
ABSTRACT: Modifying Risk for Extracorporeal Circulation: Trial of Four Anti-inflammatory Strategies. Annals of Thoracic Surgery, 1998; 66:747-754. Gott, et al.
This 400-patient study of patients undergoing CPB show a reduced length of stay and reduced hospital charges up to $6,000 in low risk patients who receive leukocyte filtration.
ABSTRACT: Cost Effectiveness of Using a Leuko-Depleting Arterial Line Filter. Proceedings of the American Academy of Cardiovascular Perfusion 1994: v 15. Palanzo D, et al.
In this study of 350 patients, the authors conclude that the use of the Pall LG6 filter improves post-bypass lung function, and results in $1,942 savings per patient.
ABSTRACT: The Effect of Leukocyte-Depleting Arterial Line Filters on Cerebral Microemboli and Neuropsychological Outcome following Coronary Artery Bypass Surgery. Eur J Cardiothorac Surg 2004; Feb;25(2):267-74. Whittaker, et al
The authors evaluate the effect of using the Pall LG6 arterial line filter on cerebral microemboli and neuropsychological outcome following bypass surgery.
ABSTRACT: Clinical Evaluation of a Leuko-Depleting Blood Cardioplegia Filter (BC1B) for Elective Open-Heart Surgery. Perfusion 1998; 13: 205-210. Suzuki, et al.
In this study of 40 CABG patients, the authors demonstrate the ability of the Pall BC1 filter to remove inflammatory mediators CPK-MB and troponin.
ABSTRACT: Clinical Benefits of Continuous Leukocyte Filtration during Cardiopulmonary Bypass in Patients undergoing Valvular Repair or Replacement. Perfusion 2005; V 20: 21-9. Sutton S, et al.
In this retrospective study of 700 patients undergoing valve surgery, the authors demonstrate significant benefits to patients who receive leukocyte filtration, including reduced time to extubation and reduced LOS.
ABSTRACT: Strategic Leukocyte Depletion Reduces Pulmonary Microvascular Pressure and Improves Pulmonary Status Post-Cardiopulmonary Bypass. Perfusion 2003; Volume 18. O-Yurvati A.
Albert O-Yurvati, DO, demonstrates the combination of leukocyte filtration and aprotinin in reducing pulmonary microvascular pressure and shunt fraction in a study of 225 CABG patients.
ABSTRACT: Clinical Effectiveness of Leukocyte Filtration During Cardiopulmonary Bypass in Patients With Chronic Obstructive Pulmonary Disease. Ann Thorac Surg 2004; 78:1339-44. Karaiskos, et al.
In this study of COPD patients undergoing CPB, the authors conclude that the use of the Pall LG6 filter results in improved respiratory index, shorter ICU and hospital LOS.
ABSTRACT: Levels of Inflammatory Markers in the Blood Processed by Autotransfusion Devices during Cardiac Surgery Associated with Cardiopulmonary Bypass Circuit. Perfusion 2002; 17:117-123. Amand, et al.
This study evaluates the ability of several cell salvage devices to remove white cells. The C.A.T.S System and Haemonetics CS5 devices removed the highest percentage of white cells.
ABSTRACT: The Role of Leukocyte Depleting Filters in Heart Transplantation: Early Outcomes in Prospective, Randomized Clinical Trial. European Journal of Cardiothoracic Surgery. October 2006; 30: 621-627. Dvorak, et al.
In this study of 40 patients, the authors find leukocyte filtration reduces markers of reperfusion injury, time on ventilation and time in the ICU, and improves graft functionality.