ABSTRACT
Objective:
We aimed to determine the hemodynamic effects of the use of vacuum-assisted venous drainage (VAVD) in open heart surgery and the risks for perfusionists.
Materials and Methods:
Patients who underwent robotic or minimally invasive open heart surgery with VAVD (n=20) and open heart surgery with traditional venous drainage (n=20) were compared retrospectively.
Results:
There was no difference between the groups in terms of demographic patient characteristics, blood pressure during cardiopulmonary bypass (CPB), pump flow, cross clamp time, pump balance, and intope requirement. However, the group 1 pump time was statistically significantly longer. In group 1, postoperative 1st day hemoglobin and leukocyte values were found to be higher than in group 2, and postoperative 2nd and 3rd day thrombocyte values were found to be lower. However, no statistically significant difference was found in terms of erythrocyte suspension, thrombocyte suspension, and fresh frozen plasma used in the perioperative and postoperative periods. There were no statistically significant differences between the groups in terms of C-reactive protein, blood urea nitrogen, creatinine, and estimated glomerular filtration rate values, and duration of intensive care unit and hospital stay. In our study, hemolysis was observed in 2 cases in group 1 and in 4 cases in group 2.
Conclusion:
It is seen that the VAVD method applied with a vacuum of -40 mmHg provides adequate CPB perfusion hemodynamics when compared with open heart surgery cases in which venous drainage is applied with the traditional method. We believe that it can be safely used in robotic and minimally invasive open heart surgery with adequate CPB perfusion hemodynamics without causing additional complications due to negative pressure with similar perioperative and postoperative outcomes.
Keywords:
Vacuum assisted venous drainage, open heart surgery, cardiopulmonary bypass, increased venous return, gravity drainageoperative parameters.
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