A Safe and Flexible Cardiopulmonary Bypass Technique for Complex Aortic Surgery without the Requirement for Deep Hypothermic Circulatory Arrest

Abstract

This article describes an adaptable technique of full-body perfusion during complex aortic surgery, which was performed on six consecutive patients, at a nasopharyngeal temperature of 28–34°C for a mean duration of 5 hours. A modified perfusion system was used to provide upper and lower body perfusion through axillary and femoral artery cannulation. The option of selective antegrade cerebral perfusion was also available if required. A simple custom-made circuit and application of additional monitoring such as cerebral oximetry makes this technique a safe and flexible method of providing continuous whole-body perfusion at moderate hypothermia and above. We found that these patients all had no major coagulopathies after the procedure and demonstrated no observable neurological, renal, or gastrointestinal dysfunction on recovery.