Abstract
Cardiopulmonary bypass causes an inflammatory response and consumption of coagulation factors, increasing the risk of bleeding and neurological and renal complications. Its use during lung transplantation may be due to pulmonary hypertension or associated cardiac defects or just for better exposure of the pulmonary hilum. We describe a simple technique, or open pericardium retraction, to improve hilar exposure by lifting the heart by upward retraction of the pericardial sac. This technique permits lung transplantation without cardiopulmonary bypass when bypass use is recommended only for better exposure.
Highlights
Since the development of bilateral sequential lung transplantation (LTx), cardiopulmonary bypass (CPB) has become unnecessary in most cases
Difficulty in exposing the left pulmonary hilum is another situation in which CPB is recommended
CPB use may have a protective effect by reducing blood flow to the newly implanted lung, its use is associated with an inflammatory reaction, coagulation disturbances, acute alveolar injury and renal and neurological complications
Summary
A simple technique can reduce cardiopulmonary bypass use during lung transplantation Marcos N. Cardiopulmonary bypass causes an inflammatory response and consumption of coagulation factors, increasing the risk of bleeding and neurological and renal complications. Its use during lung transplantation may be due to pulmonary hypertension or associated cardiac defects or just for better exposure of the pulmonary hilum. We describe a simple technique, or open pericardium retraction, to improve hilar exposure by lifting the heart by upward retraction of the pericardial sac. This technique permits lung transplantation without cardiopulmonary bypass when bypass use is recommended only for better exposure
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