Total Cardiopulmonary Support with Disposable Membrane Oxygenator During Aortocoronary Artery-Vein Graft Operations

¹ Department of Surgery, The New York Hospital-Cornell Medical Center, New York

Fifty-five patients received total cardiopulmonary support with the disposable Lande-Edwards membrane oxygenator during aortocoronary artery-vein graft operations and other complex open heart operations. Two three meter² membrane oxygenators were linked in parallel to a standard roller pump apparatus. (Three 3 meter² membranes for patients weighing 80 to 103 kg.) Excellent oxygen and carbon dioxide exchange (2 ml O₂/kg/min) occurred during hypothermia of 30°C at flows of 50 ml/kg/min during pump runs of 1 to 6 hours. Low sonar counts for microemboli were associated with platelet counts up to 200,000 per milliliters; therefore, fewer blood transfusions were needed. Plasma hemoglobin was below 50 mg percent, and the urine remained yellow except when excessive suctioning occurred. Immediate awakening and ambulation in the hallway within 24 hours, reduced lung complications and permitted earlier hospital discharge than similar patients supported with bubble oxygenator. The absence of direct blood gas interface in membrane oxygenator allows safer prolonged total cardiopulmonary support in our hands than the bubble or disc oxygenator.