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Minimalinvasive extrakorporale Zirkulation

Fakt oder Fiktion?

Minimally invasive extracorporeal circulation

Fact or fiction?

  • Kardiotechnik/EKZ
  • Published:
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Der Begriff der minimalinvasiven extrakorporalen Zirkulation (Mi-EKZ) hat sich seit wenigen Jahren etabliert. Die Akzeptanz des Konzepts in der täglichen Routine lässt allerdings an der Validität dieser Begrifflichkeit zweifeln. Das Ziel dieser Übersicht ist es, die wissenschaftlichen Grundlagen, die zu dieser Bezeichnung geführt haben, darzustellen.

Abstract

The term minimally invasive extracorporeal circulation (MiECC) has become established only over the last few years; however, the acceptance of the concept in the daily routine brings doubt to the validity of the terminology. The aim of this review is to present the scientific basis that has led to this terminology.

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Literatur

  1. Abdel-Rahman U, Özaslan F, Risteski P et al (2005) Initial experence with a minimized extracorporeal bypass system: Is there a clinical benefit? Ann Thorac Surg 80:238–244

    Article  Google Scholar 

  2. Anastasiadis K, Antonitsis P, Arfiriadou H et al (2015) Modular minimally invasive extracorporeal circulation systems; can they become the standard practice for performing cardiac surgery? Perfusion 30:195–200

    Article  CAS  Google Scholar 

  3. Anastasiadis K, Argiriadou H, Kosmidis M et al (2011) Neurocognitive outcome after coronary artery bypass surgery using minimal versus conventional extracorporeal circulation: a randomized controlled pilot study. Heart 97:1082–1088

    Article  Google Scholar 

  4. Anastasiadis K, Asteriou C, Deliopoulos A et al (2010) Hematological effects of minimized compared to conventional extracorporeal circulation after coronary revascularization procedures. Perfusion 25:197–203

    Article  Google Scholar 

  5. Anastasiadis K, Murkin J, Antonitsis P et al (2016) Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS). Interact CardioVasc Thorac Surg 22:647–662

    Article  Google Scholar 

  6. Asteriou C, Antonitsis H, Argiriadou H et al (2013) Minimal extracorporeal circulation reduces the incidence of postoperative major adverse events after elective coronary artery bypass grafting in high-risk patients. A single-institutional prospective randomized study. Perfusion 28:350–356

    Article  CAS  Google Scholar 

  7. Baumbach H, Rustenbach C, Michaelsen J et al (2014) Minimally invasive versus conventional extracorporeal circulation in minimally invasive cardiac valve surgery. Thorac cardiovasc Surg 62:42–46

    PubMed  Google Scholar 

  8. Bical O, Fromes Y, Gaillard D et al (2006) Comparison of the inflammatory response between minimized and standard CPB circuits in aortic valve surgery. Eur J Cardiothorac Surg 29:699–702

    Article  Google Scholar 

  9. van Boven W, Gerritsen W, Driessen A et al (2013) Minimised closed circuit coronary artery bypass grafting in the elderly is associated with lower levels of organ-specific biomarkers. A prospective randomised study. Eur J Anaesthesiol 30:685–694

    Article  Google Scholar 

  10. Capuano F, Goracci M, Luciani R et al (2009) Neutrophil gelatinase-associated lipocalin levels after use of mini-cardiopulmonary bypass system. Interact CardioVasc Thorac Surg 9:797–801

    Article  Google Scholar 

  11. Castiglioni A, Verzini A, Colangelo N et al (2009) Comparison of minimally invasive closed circuit versus standard extracorporeal circulation for aortic valve replacement: a randomized study. Interact Cardio Vasc Thorac Surg 9:37–41

    Article  Google Scholar 

  12. DeFoe G, Ross C, Olmstead E et al (2001) Lowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting. Ann Thorac Surg 71:769–776

    Article  CAS  Google Scholar 

  13. Donndorf P, Kühn F, Vollmar B et al (2012) Comparing microvascular alterations during minimal extracorporeal circulation and conventional cardiopulmonary bypass in coronary artery bypass graft surgery: A prospective, randomized study. J Thorac Cardiovasc Surg 144:677–683

    Article  Google Scholar 

  14. El-Essawi A, Breitenbach I, Haupt B et al (2017) Impact of minimally invasive extracorporeal circuits on octogenarians undergoing coronary artery bypass grafting. Have we been looking in the wrong direction? Eur J Cardiothorac Surg 52:1175–1181

    Article  Google Scholar 

  15. El-Essawi A, Hajek T, Skorpil J et al (2011) Are minimized perfusion circuits the better heart lung machines? Final results of a prospective randomized multicenter study. Perfusion 26:470–478

    Article  CAS  Google Scholar 

  16. El-Essawi A, Morjan M, Breitenbach I et al (2017) Modular minimal invasive extracorporeal circuits: another step towards universal applicability? Perfusion 32:598–605

    Article  Google Scholar 

  17. Fromes Y, Gaillard D, Ponzio O et al (2002) Reduction of the inflammatory response following coronary bypass grafting with total minimal extracorporeal circulation. Eur J Cardiothorac Surg 22:527–533

    Article  Google Scholar 

  18. Gunaydin S, Sari T, McCusker K et al (2009) Clinical evaluation of minimized extracorporeal circulation in high-risk coronary revascularization: impact on air handling, inflammation, hemodilution and myocardial function. Perfusion 24:153–162

    Article  Google Scholar 

  19. Habib R, Zacharias A, Schwann TA et al (2003) Adverse effects of low hematocrit during cardiopulmonary bypass in the adult: should current practice be changed? J Thorac Cardiovasc Surg 125:1438–1450

    Article  Google Scholar 

  20. Haneya A, Philipp A, Schmid C et al (2009) Minimised versus conventional cardiopulmonary bypass: outocome of high-risk patients. Eur J Cardiothorac Surg 36:844–848

    Article  Google Scholar 

  21. Huybregts R, Morariu A, Rakhorst G et al (2007) Attenuated renal and intestinal injury after use of a mini-cardiopulmonary bypass system. Ann Thorac Surg 83:1760–1767

    Article  Google Scholar 

  22. Immer F, Ackermann A, Gygax E et al (2007) Minimal ectracorporeal circulation is a promising technique for coronary artery bypass grafting. Ann Thorac Surg 84:1515–1521

    Article  Google Scholar 

  23. Kowalewski M, Pawliszak W, Raffa G et al (2016) Safety and efficacy of miniaturized extracorporeal circulation when compared with off-pump and conventional coronary artery bypass grafting: evidence synthesis from a comprehensive Baysian-framework network meta-analysis of 134 randomized controlled trials involving 22778 patients. Eur J Cardiothorac Surg 49:1428–1440

    Article  Google Scholar 

  24. Kutschka I, Skorpil J, El-Essawi A et al (2009) Beneficial effects of modern perfusion concepts in aortic valve and aortic root surgery. Perfusion 24:37–44

    Article  CAS  Google Scholar 

  25. Momin A, Sharabiani M, Kidher E et al (2013) Feasibility and safety of minimized cardiopulmonary bypass in major aortic surgery. Interact Cardiovasc Thorac Surg 17:659–663

    Article  Google Scholar 

  26. Remadi J, Rakotoarivello Z, Marticho P et al (2004) Aortic valve replacement with the minimal extracorporeal circulation (Jostra MECC System) versus standard cardiopulmonary bypass: a randomized prospective trial. J Thorac Cardiovasc Surg 128:436–441

    Article  CAS  Google Scholar 

  27. Remadi JP, Rakotoarivelo Z, Marticho P et al (2006) Prospective randomized study comparing coronary artery bypass grafting with the new mini-extracorporeal circula- tion Jostra System or with a standard cardiopulmonary bypass. Am Heart J 151:198e1–198e7

    Article  Google Scholar 

  28. Rimpiläinen R, Hautala N, Koskenkari J et al (2011) Minimized cardiopulmonary bypass reduces retinal microembolizazion: a randomized clinical study using fluorescein angiography. Ann Thorac Surg 91:16–23

    Article  Google Scholar 

  29. Sakawa M, Emery R, Shannon F et al (2009) Coronary artery bypass grafting with a minimized cardiopulmonary bypass circuit: a prospective, randomized trial. J Thorac Cardiovasc Surg 137:481–485

    Article  Google Scholar 

  30. Sun Y, Gong B, Yuan X et al (2015) What we have learned about minimized extracorporeal circulation versus conventional extracorporeal circulation: an updated meta-analysis. Int J Artif Organs 38:444–453

    Article  Google Scholar 

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Correspondence to Aschraf El-Essawi.

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Interessenkonflikt

A. El-Essawi: Beziehungen zu teils honorierten Lehr‑, Vortrags- und Beratungszwecken bestehen mit folgenden Firmen: Terumo und Medtronic. J. Gehron erhielt Vortragshonorare der Getinge Deutschland, Keller Medical und Terumo. A. Böning: Beziehungen zu teils honorierten Lehr‑, Vortrags‑, Studien- und Beratungszwecken bestehen mit folgenden Firmen: Zoll, Bayer, Maquet, Orion Pharma, Smith & Nephew, Somahultion, Spectranetics, Abbott, B. Braun, Nordic Pharma, Astra Zeneca, Quark Pharmaceuticals, Boston Scientific, Biom UP, Atricure und Mitsubishi Pharma. A. Bauer, S. Gröger, H. Hausmann und W. Harringer geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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El-Essawi, A., Bauer, A., Gröger, S. et al. Minimalinvasive extrakorporale Zirkulation. Z Herz- Thorax- Gefäßchir 34, 108–114 (2020). https://doi.org/10.1007/s00398-019-00349-y

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  • DOI: https://doi.org/10.1007/s00398-019-00349-y

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