Coronary bypass surgery performed without the use of cardiopulmonary bypass (off-pump surgery) has been used sporadically since the beginning of the bypass surgery era in 1967, but the use of this strategy increased dramatically during the 1990s. The major reason for the increased use of off-pump surgery was the hope that this strategy would decrease perioperative morbidity and possibly mortali...

Cardiopulmonary bypass has revolutionized the ability to provide cardiorespiratory support and has advanced the field of cardiac surgery. This invention has given surgeons the ability to perform many procedures that were not possible previously. The concept and development of cardiopulmonary bypass has been pioneered by numerous legendary surgeons. Cardiopulmonary bypass, extracorporeal membran...

OBJECTIVE To investigate the effects of preoperative simvastatin treatment on leucocyte-endothelial interactions following coronary artery bypass surgery with cardiopulmonary bypass. DESIGN Double blind crossover study. Experiments on polymorphonuclear cells (neutrophils) were done at the end of cardiopulmonary bypass and one hour postoperatively. Endothelial P-selectin expression and neutrop...

There seems to be a wide range of practice in relation to the optimum oxygen setting before, and at the start of, cardiopulmonary bypass. Even manufacturers of blood oxygenators vary in their suggestions for this phase of extracorporeal circulation. Most of these suggestions are based on peak performance, Association for the Advancement of Medical Instrumentation (AAMI) standards, experience, a...

Patients who receive desmopressin acetate (dDAVP) after cardiopulmonary bypass bleed less during operation and in the first 24 hours after operation than do patients who receive a placebo. To study the mechanism of improved hemostasis in bypass patients, we examined the relationship between von Willebrand factor (vWF) and blood loss in 70 cardiopulmonary bypass patients, one-half of whom receiv...

Epicardial cysts originating directly from the epicardium are seen very rarely. Complete surgical excision is recommended when these cysts are detected. If cysts compress surrounding vital structures, cardiopulmonary bypass (CPB) should also be considered. We report herein 2 cases of multiloculated epicardial cysts, both of which were successfully excised, 1 with CPB.

What is a standard of care? Who defines standard of care? And when does new technology, such as continuous in-line blood gas monitoring (CILBGM), become a standard of care? Perhaps the most productive and practical way to view standards of care in perfusion is as, "the best perfusion management we can provide for our patients within reason and affordability." Today, CILBGM offers a tangible pat...

The authors comment on Steffens and Gunser's article describing the University of Wisconsin adoption of the Epic anesthesia record to include perfusion information from the cardiopulmonary bypass patient experience. We highlight the current-day lessons and the valuable quality and safety principles the Wisconsin-Epic model anesthesia-perfusion record provides.