Reader comments and any reflections from those who attend these perfusion-related conferences are most welcomed as posts to the comments section.
Ralph E. Jordan
CEO & President
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April 9-12, 2008
Greg Gagnon BS. C.C.P.
On Wednesday April 9th, the first lecture I chose to see was the Tandem Heart PTVA system. This ventricular assist device was an example of how perfusionists can be of help to patients in and out of the operating room. Several case reports were provided showing the Tandem Hearts ease of use and flexibility.
The main purpose for this device is to provide patients support in post cardiotomy shock. This particular device may also be used in the cath lab for support for patients undergoing PTCA and Valvuloplasty procedures. There were also examples given using the VAD for transport and as a Bridge to transport.
This device was totally percutaneous. This allows for not only CT surgeons also Interventional Cardiologists to take advantage of this pump for their patients. The pump uses a mini centrifugal pump that is about 2.5 inches in diameter. The pump is connected to the control box via a thin drive line which looked like a large I.V. pump. The system uses very little heparin that is used to keep the pump lubricated.
I thought this could be used in many settings; however the cost was pretty high. The system was very expensive. The disposables run about 20,000 dollars and last 2 years on the shelf. The company allows for one exchange of expired disposables once every four years.
Later, I attended the virtual OR sessions. On display were standard pump consoles that used mini circuits. One pump setup that caught my attention was provided by Jeffery Mowery BS CCP from University Hospitals of Cleveland – Case Medical Center. This pump setup used a Terumo Pump pack and an RX25 oxygenator. The priming volume for this setup was one liter.
On April 10th, I chose to attend track one of the conference. This was billed as “Blood Management”.
Bradley Kulat, BA CCP LP from Children’s Memorial Hospital Chicago, IL presented “Optimizing Circuit Design Using a Remote Mounted Perfusion System”. His system used a remote pump head that was placed high up next to the cardiotomy with all the roller pumps in a “V” formation. They customized every circuit which allowed them to reduce blood usage by 65%, and priming volumes by 45%.
There were two presentations that followed that left me confused. The first was “Aprotinin is unnecessary in Redo coronary and Valve surgery” presented by Priya Sastry MD of Liverpool England.
She compared blood loss totals in patients undergoing redo CABG and Valve Surgery with and without Aprotinin and determined there to be little difference between the two. She did say that with redo MVR surgery a more detailed look was warranted to determine if there was any evidence that would show that Aprotinin was beneficial to patients.
This lecture seemed a bit out of place to me as Aprotinin is not available in the U.S.
The second lecture was presented by Michael Polis MD. He is a CT fellow from Liverpool England. His presentation was titled Haemofiltration on Bypass is potentially Associated with Cerebral Oedema: A Theoretical Analysis. I was very interested in this particular presentation because of my use of the Hemobag system which requires us to aggressively hemoconcentrate our patients.
I had hoped to hear more about hemoconcentrating and its effect on the brain, but this was only a theoretical analysis.
On Friday the 11th I attended a lecture regarding “An in Vivo investigation of five Integral Cardiotomy Reservoirs for Gaseous Microemboli Activity During Venting”. This lecture I thought was very informative. Five oxygenators were compared for their handling of micro air bubbles being pulled in from the cardiotomy. The Terumo RX25 was superior in its handling of micro air.
All in all I thought the meeting was average. Many times it was very difficult to hear the responses of the lecturers during the question and answer phase. They would turn away from the microphone and speak directly to the moderator. I did enjoy the virtual operating room presentations. I felt that the minimal prime setups were very practical informative.
