Traditional cardiopulmonary bypass (CPB) techniques have suffered from a number of disadvantages including haemodilution, inflammation and post-operative bleeding. Minimised cardiopulmonary bypass techniques use developments in perfusion technology to significantly reduce foreign surface-blood interactions to make bypass simpler and safer. This important book reviews key developments and issues relating to this promising technology. Part one covers the broad range of CPB pathophysiology, including anticoagulant protocols, the impact of CPB circuit surfaces, optimal haemodilution levels, and the important issue of CPB-induced systemic inflammatory response syndrome. Part two focuses on the issues of the new equipment developed for mini-CPB, optimal myocardial protection protocols and CPB perfusate options. Part three discusses clinical issues, including patient selection, coronary and valve surgery protocols and, among others, paediatric patients. With its distinguished editors and international team of expert contributors, Minimized cardiopulmonary bypass techniques and technologies is a valuable reference for cardiac surgery teams and those researching this important technology.

Table of Contents:
Contributor contact details Foreword Chapter 1: Historical development of minimised cardiopulmonary bypass Abstract: 1.1 Introduction and historical perspective 1.2 Cardiopulmonary bypass: from pioneering to refinement 1.3 Cardiopulmonary bypass: does size matter? 1.4 Conclusions Chapter 2: Anticoagulation protocols for minimized cardiopulmonary bypass Abstract: 2.1 Introduction: blood activation during cardiac surgery with cardiopulmonary bypass (CPB) 2.2 Anticoagulation during CPB: basic principles and historical notes 2.3 Heparin-bonded surfaces and other biocompatible treatments 2.4 Reduced systemic heparinization (RSH) 2.5 Contraindications 2.6 Future trends Chapter 3: Minimized extracorporeal circulation: physiology and pathophysiology Abstract: 3.1 Introduction: basic principles 3.2 The inflammatory cascade and biomarkers 3.3 Conclusions Chapter 4: Blood–surface interface in miniaturised extracorporeal circulation systems Abstract: 4.1 Introduction 4.2 Blood–surface contact in cardiopulmonary bypass (CPB) 4.3 Clinical benefits of miniaturised extracorporeal circulation systems Chapter 5: Hemodilution: physiology and pathophysiology Abstract: 5.1 Introduction 5.2 Basic physiology and pathophysiology of hemodilution 5.3 Microvascular alterations with hemodilution 5.4 Hemodilution and cardiopulmonary bypass (CPB) 5.5 Determinants of tissue oxygenation – functional capillary density (FCD) 5.6 Conclusions Chapter 6: Inflammatory response and minimized cardiopulmonary bypass Abstract: 6.1 Introduction 6.2 Cardiopulmonary bypass (CPB)-induced inflammatory cascade 6.3 Pharmacological antioxidants for CPB: impact on biochemical and clinical outcomes 6.4 Minimized CPB circuits 6.5 Acknowledgements 6.7 Appendix: abbreviations Chapter 7: Design and principles of the minimized extracorporeal circuit Abstract: 7.1 Introduction 7.2 Basic principles of minimized extracorporeal circulation 7.2 Evolution of minimized circuits 7.4 Minimized extracorporeal systems currently available 7.5 Surgical applications of minimized extracorporeal circulation 7.6 Controversies and challenges facing minimized cardiopulmonary bypass 7.7 Future trends in minimized cardiopulmonary bypass Chapter 8: Cardiopulmonary bypass perfusate Abstract: 8.1 Introduction 8.2 Crystalloid primes 8.3 Types of crystalloids and colloid agents used in prime 8.4 Pharmacological agents used in prime 8.5 Using prime in CPB procedures 8.6 Examples of prime combinations 8.7 Minimizing the use of prime 8.8 Conclusions Chapter 9: Myocardial preservation techniques for mini-bypass Abstract: 9.1 Introduction 9.2 Methods of myocardial protection 9.3 Myocardial protection in mini-bypass 9.4 Conclusion Chapter 10: Minimised cardiopulmonary bypass: objectives and indications Abstract: 10.1 Introduction: objectives of minimised cardiopulmonary bypass 10.2 Indications and patient selection 10.3 Future trends Chapter 11: Coronary artery bypass grafting (CABG) Abstract: 11.1 Introduction 11.2 History of coronary artery bypass grafting (CABG) 11.3 Patient selection (indications) for mini-invasive cardiopulmonary bypass 11.4 Conduits 11.5 Anastomoses techniques 11.6 Surgical management on mini-invasive cardiopulmonary bypass 11.7 Conclusions Chapter 12: Valve surgery using minimized perfusion circuits Abstract: 12.1 Introduction 12.2 Surgical and technical aspects 12.3 Blood management and patient treatment in valve surgery 12.4 Experience with closed-loop perfusion circuits in valve surgery Chapter 13: Minimising cardiopulmonary bypass in children Abstract: 13.1 Introduction 13.2 Challenges of cardiopulmonary bypass (CPB) in the congenital patient 13.3 Potential goals of mini-CPB 13.4 Mini-CPB and neurological outcome 13.5 Mini-CPB circuit design options in congenital heart surgery 13.6 Clinical trials 13.7 Alternative procedures to CPB 13.8 Conclusions 13.10 Appendix: abbreviations Chapter 14: Comparison of minimized circulation with off-pump coronary artery bypass (OPCAB) grafting and conventional surgery Abstract: 14.1 Introduction 14.2 Controversies and challenges facing off-pump coronary artery bypass (OPCAB) grafting 14.3 Studies comparing OPCAB with mini-cardiopulmonary bypass (mini-CPB) and mini-CPB assisted OPCAB 14.4 Future trends and competition between OPCAB and minimized cardiopulmonary bypass Chapter 15: Minimally invasive cardiac surgery, port-access and robotic surgery Abstract: 15.1 Introduction 15.2 Minimally invasive coronary artery bypass grafting 15.3 Minimally invasive valve surgery 15.4 Minimally invasive congenital surgery 15.5 Minimally invasive treatment of atrial fibrillation 15.6 Miscellaneous possibilities of minimally invasive surgery 15.7 Robotic surgery 15.8 Conclusions Index