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    Cardiopulmonary Bypass

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    Nidya Putri
    1. Cardiopulmonary bypass provides a bloodless, motionless field for open-heart surgery by diverting blood flow away from the heart and lungs. 2. It drains venous blood, oxygenates it through an artificial lung, and pumps the oxygenated blood back using an artificial heart while the patient's heart and lungs are stopped. 3. This allows surgeons to operate on the heart while its function is temporarily replaced by the bypass machine.

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    Cardiopulmonary Bypass

    Uploaded by

    Nidya Putri
    98 views62 pages
    1. Cardiopulmonary bypass provides a bloodless, motionless field for open-heart surgery by diverting blood flow away from the heart and lungs. 2. It drains venous blood, oxygenates it through an artificial lung, and pumps the oxygenated blood back using an artificial heart while the patient's heart and lungs are stopped. 3. This allows surgeons to operate on the heart while its function is temporarily replaced by the bypass machine.

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    1. Cardiopulmonary bypass provides a bloodless, motionless field for open-heart surgery by diverting blood flow away from the heart and lungs. 2. It drains venous blood, oxygenates it through an artificial lung, and pumps the oxygenated blood back using an artificial heart while the patient's heart and lungs are stopped. 3. This allows surgeons to operate on the heart while its function is temporarily replaced by the bypass machine.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    98 views62 pages

    Cardiopulmonary Bypass

    Uploaded by

    Nidya Putri
    1. Cardiopulmonary bypass provides a bloodless, motionless field for open-heart surgery by diverting blood flow away from the heart and lungs. 2. It drains venous blood, oxygenates it through an artificial lung, and pumps the oxygenated blood back using an artificial heart while the patient's heart and lungs are stopped. 3. This allows surgeons to operate on the heart while its function is temporarily replaced by the bypass machine.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 62

    Cardiopulmonary

    Cardiopulmonary Bypass
    Bypass

    Jiang Yingjiu
    Associate Professor
    Master Tutor

    Cardiothoracic Department
    The First Affiliated Hopital of Chongqing Medical University
    Congenital heart disease,Tetralogy of Fallot
    6 years old,15 kg weight.
    cyanosis,clubbing fingers.

    wouldn’t grown-up
    unless recieved cardiac surgery
    To repair the cardiac defects

    Bloodless field
    Motionless field

    Stop the motion of the heart


    and lungs
    Bloodless?

    Motionless?

    Life maintenance?
    Cardiopulmonary
    Cardiopulmonary Bypass
    Bypass
    1 Definition
    2 Basical equipments
    3 Essential steps
    4 Clinical application
    5 Pathophysiology
    6 Postoperative treatment
    Cardiopulmonary
    Cardiopulmonary Bypass
    Bypass

    Drains venous blood from the right atrium or vena cava by the
    cannula inserted into the venous system.Finishs gas exchange
    process including oxygen and carbon dioxide by the artifial
    lung(oxygenator) to change the oxygen poor venous blood
    into the oxygen rich arterial blood.Pumps oxygenated blood
    back to the body by the artificial heart(pump) via arterial
    cannula to remain the living of the all the other organs of the
    body except the lung and the heart.
    Provides a limited 2-3 hours time during which the lung and
    the heart are not working for cardiac surgeon to open the heart
    and finish a operation precisely with bloodless and motionless
    field.
    By this way,the function of the lung and heart had been
    taken over by the extracorporeal circulation equipments.
    Provide the desired bloodless, motionless operative field
    and still supply all the other organs of the body with
    oxygen and nutrient-rich blood.
    Heat exchanger
    Summary for CPB

    1 Purpose:
    1) To provide a bloodless, motionless field for heart surgery
    2) Rest of body perfused while heart and lung stopped

    2 Methods:
    1) Drain out venous blood
    2) Oxygenated by artificial lung
    3) Oxygen-rich blood pumped back by artificial heart
    History
    Landmark in cardiac surgery!

    Western countries in 1953


    China in 1958

    The hospital here


    1963
    1979
    John H. Gibbon
    吴英恺
    1 Definition
    2 Basical equipments
    3 Essential steps
    4 Clinical application
    5 Pathophysiology
    6 Postoperative treatment
    Basic equipments
    1 artificial heart (blood pump)
    2 artificial lung (oxygenator)
    3 temperature exchanger
    4 filter
    5 tubes or cannulas

    Artificial
    Artificial hypothemia
    hypothemia

    Using bionics principle of hibernation ， lowering the body


    temperature can strengthen the tolerance ablility for hypoxia.
    Decreasing 1 ℃ of the body temperature can reduce oxygen
    consumption by 5%-6%. Decrease the body temperature to 28 ℃
    -20 ℃, the metabolization will be reduced to 50%-80%. Therefore,
    low temperature can enhance the body tolerance to hypoxia.
    Combine the cardiopulmonary bypass and hypothermic anesthesia
    together widely used in the treatment of heart disease for open
    intracardio surgery.
    temperature exchanger

    tubes
    blood pump

    oxygenator
    1 Definition
    2 Basical equipments
    3 Essential steps
    4 Clinical application
    5 Pathophysiology
    6 Postoperative treatment
    Typical process for open heart surgery

    1 Anesthesia
    2 Supine position
    3 Median sternotomy
    4 Incision of the skin and subcutaneous
    5 Sternum divided by saw
    5 Thymus isolated
    6 Incision of pericardium
    7 Heart and great vessels exposed

    8 Heparinize

    9 Exterior exploration

    Chest opened by sternotomy


    10 Cannulations for aorta,SVC,IVC
    11 Connect cannulations to cardiopulmonary
    bypass machine
    the bypass system established
    12 Start the bypass machine and
    hypothermia
    13 Aortic cross-clamp placed
    cardioplegia injected
    the heart arrested
    14 Open the heart ………..

    exploration and operation


    Cardiopulmonary Bypass
    Technique
    Cardiopulmonary Bypass
    Technique

    Arterial & Venous Cannulation


    Myocardial Protection
    Strategies:
    1 Hypothermia
    cold perfusate
    surface cooling

    2 Cardioplegia
     K+
    diastolic arrest Intermittent perfusion
    Myocardial Protection
    Cardioplegia:

     Route of administration

    Antegrade Retrograde
    Nonpulsatile / pulsatile flow
    C.O. - 2-2.5 L/min/m2

    CPB under going


    15 Re-warming
    de-air
    release aortic clamp
    heart resuscitation
    heart beating again
    16 Heart incision suture
    17 Off pump gradually
    remove the pipelines
    18 Administration of protamine
    neutralize against heparin
    restore clotting function
    19 Sternal fixation with wire
    20 Close the skin incision
    Anesthesia
    Median sternotomy
    Incision of pericardium
    Exterior exploration
    Heparinize
    Cannulations for aorta,SVC,IVC
    Start the bypass machine and
    hypothermia
    Aortic cross-clamp placed
    Cardioplegia injected
    Intracardiac exploration and
    open-heart operation
    Re-warming,de-air,release aortic
    clamp,heart resuscitation
    Off pump gradually
    Neutralize against heparin
    restore clotting function
    Sternal fixation with wire
    Close the skin incision
    1 Definition
    2 Basical equipments
    3 Essential steps
    4 Clinical application
    5 Pathophysiology
    6 Postoperative treatment
    Clinical application:

    All the operations need open the heart

    Congenital heart disease

    Cardiac valve disease

    Coronary artery disease

    Great vessel disease

    Extended radical operation for various chest tumor


    Congenital heart disease
    Cardiac valve disease
    Coronary artery disease
    Great vessel disease
    1 Definition
    2 Basical equipments
    3 Essential steps
    4 Clinical application
    5 Pathophysiology
    6 Postoperative treatment
    Pathophysiology after bypass

    1 Metabolic changes: acidosis and alkalosis

    2 Electrolytes turbulence: hypokalemia

    3 Blood damage: blood cell damage,coagulation disorder

    4 Renal or lung function decrease or damage


    1 Definition
    2 Basical equipments
    3 Essential steps
    4 Clinical application
    5 Pathophysiology
    6 Postoperative treatment
    1 Haemodynamic stability

    2 Correcting acid-base imbalance

    and electrolyte disturbance

    3 Protection of renal function

    4 Assisted mechanical ventilation


    1 Definition
    2 Basical equipments
    3 Essential steps
    4 Clinical application
    5 Pathophysiology
    6 Postoperative treatment
    Thanks

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