Small Heart-Lung Machine May Lead to Faster Recovery

A compact heart-lung bypass system, slightly larger than a soda can, has been shown to be safe and effective in reducing the blood trauma and morbidity often associated with the use of conventional heart-lung machines in bypass surgery. The system is designed for use in both stopped-heart and beating-heart surgery and also for valve replacement and repair procedures.

Compared to conventional systems, the new system is able to function with one-tenth the amount of surface area exposed to blood and with minimal or no priming volume required for activating the system. By reducing hemodilution and the surface area exposed to blood, the system is expected to minimize platelet loss, blood damage, blood transfusions, and systemic inflammation. Called Corx, the system is manufactured by CardioVention Inc. (Santa Clara, CA, USA). In a recent feasibility study, surgeons from three medical centers tested the system in seven patients undergoing cardiopulmonary bypass (CPB) with good results.

"This is the first major advance in heart-lung bypass technology in more than 20 years,” said Dr. Valavanur Subramanian, chairman of the department of surgery at New York's Lenox Hill Hospital (NY, USA). "Using the Corx heart-lung machine is like going from a mainframe computer to a laptop. Because the system maintains excellent hemodynamics, it should enable better heart access in beating-heart procedures.”

CPB can have harmful short- and long-term effects, including the risk of stroke, memory loss, immunosuppression, systemic inflammation, postoperative blood loss, and organ dysfunction. CardioVention believes its Corx system may enable new minimally invasive techniques to be performed by providing assisted heart-lung support on an intermittent or continual basis. Because of its small and efficient size, the system's fluid circuitry minimizes foreign surface contact while providing optimal oxygen and carbon dioxide transfer and maximum micro-air filtration.

"In our first patient who underwent a triple bypass, the Corx system only required 100 cc of hemodilution rather than the 2,000 cc typically needed with a standard CPB,” said Dr. Jose Navia, chief surgeon at Hospital Austral in Buenos Aires (Argentina). "Platelet count showed only an 8% decline compared to 50-90% seen with conventional systems.”




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