Minimal extracorporeal circulation with integrated opto-electrical suction device and air elimination (MECC Cardiosmart)

Objectives: Shear stress and foreign surfaces have been blamed for the damage and activation of blood components. The major source for hemolysis is the cardiotomy suction driven by a roller pump which is not selective and aspirates blood and air. Recently, minimized extracorporeal circuits (MECC) driven by centrifugal pumps were introduced. These systems act as closed circuits and avoid blood-air interaction. Therefore, conventional cardiotomy suction cannot be integrated in MECC. Cardiosmart is a new suction device where the aspiration of blood is controlled by an opto-electrical sensor which minimizes the aspiration of air. We report the first clincical experience with MECC and the integrated Cardiomsart suction device.

Material and Methods: 20 patients scheduled for elective CABG were selected prospectively for MECC. The Cardiosmart suction device was directly incorporated in the MECC-circuit and the collected blood was actively retransfused through the venous inlet of the centrifugal pump.

Results: There was no mortality and no morbidity like MI, stroke or revision. Stay on ICU was <24h in all patients. 3600ml (2500ml per hour of MECC) were aspirated by Cardiosmart. This blood was retransfused to achieve a normovolemic condition throughout the intervention. Mean PB was substantially higher (80mmHg) compared to standard CPB (45mmHg. Hematocrit initially was 35.3% (29%-41%) and dropped to 27.5% (21–36%). Two patients required two units of packed red cells perioperatively.

Conclusions: Cardiosmart can be incorporated in the MECC system which is driven by a centrifugal pump. Additional trauma induced by a cell saver or a suction device driven by a roller pump can be avoided.