Proceedings

One Hundred Consecutive Perfusions Over Five Hours

Milwaukee Heart Surgery Associates, S.C., Milwaukee, Wisconsin

^* Address correspondence to: Jeffrey Peters. C.C.P., 3112 W. Highland Blvd., Milwaukee, WI 53208.

Abstract

Complete surgical treatment of severe, diffuse coronary artery disease requires long perfusion time. We reviewed 100 consecutive perfusions longer than five hours (from a total of 675, operated May, 1980, through May, [1981]). No case was excluded.

The 100 patients received 517 grafts, 217 coronary endarterectomies, 12 valves, and 12 aneurysmectomies; 98 had three vessel disease and 22 severe ventricular dysfunction. High flow, high pressure perfusion with physiologic blood gases was used.

Filters were used on cardiotomy return and arterial lines. Body temperature was kept 30–34°C at the preference of the surgeon. Intermittent ischemic arrest was used to preserve the myocardium. There were nine hospital deaths. Complications in the survivors included two instances of adult respiratory distress syndrome, one instance of stroke, and one of perioperative infarction. No patients were taken back for postoperative bleeding.

We conclude that, in view of the severity of disease, deaths and complications were well within acceptable limits.

Long perfusions, greater than five hours, did not contribute significantly to morbidity and mortality. Patients were perfused as long as necessary to achieve total revascularization.