Issue |
J Extra Corpor Technol
Volume 22, 1990
Proceedings of AmSECT’s 28th International Conference
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Page(s) | 1 - 4 | |
DOI | https://doi.org/10.1051/ject/199022S001 | |
Published online | 23 August 2023 |
Original Article
Fellowship award in cardiovascular perfusion: Perfusion Techniques of Profound Hypothermia and Circulatory Arrest for Pulmonary Thromboendarterectomy
University of California, San Diego Medical Center, San Diego, CA
* Address correspondence to: Mary H. Winkler, RN, CCP, Cardiovascular Perfusion Inc., 7910 Frost Street, Suite 204, San Diego, CA 92123-2731.
One hundred ninety-five patients with the diagnosis of chronic pulmonary thromboembolic pulmonary hypertension have been operated on utilizing a standardized protocol involving profound hypothermia and circulatory arrest. A small subgroup, nine, were identified preoperatively as having heparin-associated thrombocytopenia (HAT). This challenging subgroup of patients was treated during heparin exposure with an investigational, “platelet disaggregating” agent, Iloprost.
The surgical procedure of pulmonary thromboendarterectomy requires multiple periods of circulatory arrest under profound hypothermia. Perfusion management of this procedure involves cerebral and myocardial protection, cooling, reperfusion at hypothermia and rewarming, treatment with Iloprost when appropriate, and methods of hemodilution.
Key words: Pulmonary thromboendarterectomy / profound hypothermia and circulatory arrest / heparin-induced thrombocytopenia / iloprost / cerebral protection
© 1990 AMSECT
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