Customizing Your ECC

Editor’s Note: At some point in time, we have all had (or will have) the opportunity to customize our pump packs (ECC) in order to make them more efficient, adjust or integrate to new techniques, reduce cost, adjust to new clinical expectations from the surgeon, or minimize priming volume. So today, that was exactly what […]

Perfusion Art: “My Colleagues”

  “My Colleagues”    ________Click image to enlarge Photographer:  Suneel Lakki Equipment:  Digital Editing:  Photoshop:  Metal Gradient. Narrative: Eyes up & Eyes down Time & Place:   2014 Fortis Memorial Research Institute About The Picture:  Eye contact has been made… To View The Entire Gallery- Click the Image Below To Submit A Picture: email:  EccLog@gmail.com

Perfusion Art: “Transeptal RA to LA”

“Transeptal RA to LA”    ________Click image to enlarge Sketch Artist:  Brian White Equipment:  Pen & Projector Editing:  Photoshop:  Cropping: Hue & Contrast adjustments. Narrative: Sometimes art is needed to understand the entire picture. Transeptal RA to LA off load cannula with VA ECMO. Time & Place:   2014  West Texas About The Picture:  Sometimes you gotta get artistic […]

Perfusion Art: “Timid”

“Timid”    ________Click image to enlarge Photographer:  Frank Aprile, BBA, LP, CCP Equipment:  Digital Editing:  Photoshop:  Cropping: Hue & Contrast adjustments. Narrative: Scrubbed in for 1 hour- and gloves are totally clean… Time & Place:   2014  West Texas About The Picture:  During-Bypass To View The Entire Gallery- Click the Image Below To Submit A Picture: email:  EccLog@gmail.com

International CQI: USA: Total Oxygenator Failure

Operation: ACB x 3. Pt. Data 70 years old Gender: Male 71 inches 79 Kilograms 1.94 BSA Baseline Hematocrit- 44% Pertinant Hx: Unremarkable. No coagulopathic issues No other issues-  patient appeared to be  robust and healthy. Plan: ACB x 3:  Mild Hypothermia- 34 degrees C.. Prime Constituents: 300 ml  Normosol 5,000 units heparin 37.5 g […]

Perfusion Art: “Heart Surgery in Texas”

“Heart Surgery in Texas”    ________Click image to enlarge Editor’s Note: This is a great picture- Nikki going to town right b4 a heart case. Photographer:  Nikki’s Friend Equipment:  Digital Editing:  Photoshop:  Cropping: Hue & Contrast adjustments. Narrative: Riding herd before a heart case. Time & Place:   2014  West Texas About The Picture:  Before-Bypass To View The Entire […]

Perfusion Art: “B F F”

“B F F”    ________Click image to enlarge Photographer:  Cik Abul Equipment:  Digital Editing:  Photoshop:  Cropping: Hue & Contrast adjustments. Narrative: Malaysian perfusionist:  “The Clamp is BFF” Time & Place:   The World: 2014 About The Picture:  Before-Bypass About The Artist: I Think this says it all 🙂 To View The Entire Gallery- Click the Image Below To […]

Perfusion Art: “Breakfast Club”

“Breakfast Club”    ________Click image to enlarge Photographer:  Dario Fichera Equipment:  Digital Editing:  Photoshop:  Cropping: Hue & Contrast adjustments. Narrative: Typical chats B4 Bypass Time & Place:   The World: 2014 About The Picture:  Before-Bypass About The Artist: I Think this says it all 🙂 To View The Entire Gallery- Click the Image Below To Submit A Picture: email:  EccLog@gmail.com

Perfusion Art: “Oximetry”

“Oximetry”    ________Click image to enlarge Editor’s Note: This is a great picture- but it is also a great addition to our practice. The CASMED FORE-SIGHT Cerebral Oximeter has definitely improved our insight (in terms of adequacy of cerebral perfusion). Click Here to see the Technical Specs… Photographer:  Frank Aprile, BBA, LP, CCP Equipment:  Digital Editing:  Photoshop:  […]

FORE-SIGHT: Anticipating and Mediating Cerebral Ischemia?

Click Image to view corporate site. Editor’s Note: I used the FORE-SIGHT cerebral oximeter, the other day on a patient with documented carotid disease.  I watched the monitor closely for changes as the changes were made while on bypass (Q, pressure, sweep gas, temperature, cardiac index, X-clamping, cardioplegia, and so forth). It is a sensitive […]

The Avalon Bi-Caval Dual Lumen Catheter

Have you used a percutaneous venous cannula like this? The AVALONELITE :  Bi-Caval Dual Lumen Catheter (Click image to visit website) A Discussion on Cannula Positioning Proper cannula positioning in single site veno-venous extracorporeal life support (vv-ELS) is cumbersome and necessitates image guidance to obtain a safe and stable position within the heart and the […]

When Your Valve Specialist- Becomes Your Teacher…

Matt Braga, Southwest Region Manager (Medtronic), getting us prepped for the Lab. Editor’s Note: There are a few things I have missed in my career development, one of which was direct hands-on experience 1st assisting on open-heart procedures, and and valve operations.  It seems I always 1st assisted at institutions that didn’t do open-hearts. Well, […]

VAD’s & Device Availability List

A ventricular assist device (VAD) is a mechanical circulatory device that is used to partially or completely replace the function of a failing heart. Some VADs are intended for short term use, typically for patients recovering from heart attacks or heart surgery, while others are intended for long-term use (months to years and in some […]

Cerebral Oximetry: FORE-SIGHT versus Hindsight

Click Image to view corporate site. Editor’s Note: I have used BIS monitoring forever, and have always found it a very valuable tool. So recently I get an email from a guy named Eric Sughrue, and some stuff about the FORE-SIGHT cerebral oximeter. At first I wasn’t that interested, but he was exceptionally polite, professional, […]

HELP ! Looking for Medos Oxygenators

Editor’s Note: I received an email today regarding the Medos pediatric oxygenator: “Frank, browsing for a supply of pediatric oxy’s and found your post on the Medos oxygenator system. I used this once eons ago in Italy- worked superbly. I want to try to get some for a big project. Any contacts out there?” Jeffrey […]

Street_ECMO

Click images to enlarge Editors Note: I got an email from my overseas friend, Dario Fichera, an Italian perfusionist that is very involved in the international perfusion community. (Dario has been involved in perfusion mission work to Africa .) Below are some pictures of a mobile ECMO (Street ECMO) emergency aid station that the Italians […]

An Italian ECMO Transport

Click image to view source article Editor’s Note: I don’t know a lick of Italian, but the pictures were cool, the article was on an Italian perfusion FB group page, the concept is universal, and I wanted to put out an article in Italian to express the flexibility of this Circuit Surfers blog. It’s for […]

The Jena Universal Perfusion System

Click image above to view source article A Universal Cardiopulmonary Bypass Circuit for Cardiac Surgery The system was developed as a universal cardiopulmonary bypass circuit for cardiac surgery. The central part is a new type of reservoir, which is an assembly of two components:  the lower half is comparable to a standard hard-shell reservoir as […]

Perfusion Techniques: Parallel Oxygenators

Perfusion Techniques: Parallel Oxygenators  _____Click image to enlarge Perfusionist:  Randy Ransom, CCP Equipment:  FX25 Terumo Oxygenators x 2 / Tubing and “Y” connectors Issues:  None Narrative:  Large Patient:  Preoperative adjustment: Bumped up the ECC capacity  to 2 oxygenators setup as a parallel circuit. Time & Place:   2013 About The Perfusionist:  CCP Click to Donate Click […]

Career Perfusionist: [13] The Extracorporeal Circuit

The Extracorporeal Circuit Diversion of blood from the operative site, via an extracorporeal circuit (ECC) is necessary to proceed with open heart surgery .  Vascular access leading to the right side of the heart (venous) and ejecting from the left side of the heart (arterial) is shunted from the patient to the heart lung machine. […]

VAD / ECMO Policy: Generic & Universal

Editor’s Note: This is a disclaimer: As with all material presented on this site,  please use your own judgement as to what you feel is clinically safe, vetted, and makes sense to you.  This blog is NOT peer reviewed or sanctioned by any perfusion associated review board or academic body. That is not to say […]

The CentriMag VAD : Insertion & Cannulaes

The CentriMag Pump Display Console and Drive Units Operative Technique RVAD The right ventricular assist device (RVAD) is usually established with the right atrium as the inflow and the main pulmonary artery as the outflow. LVAD The outflow of the LVAD is the ascending aorta except in unusual cases where the descending aorta or a […]

Cardiac Assist Devices for Patients Ineligible for Transplant

Click image to view source article Bridges? Jarvik Heart, a New York-based maker of miniaturized heart assist devices announced Monday that the company has received regulatory approval for a clinical trial designed to test a ventricular assist device for end-stage heart failure patients. The patients are those that are not candidates for an eventual heart […]

New Technologies: The Hemobag:

Editor’s Note: A friend of mine asked me for my opinion of the Hemobag, a blood-salvaging device designed for whole blood recovery of residual post-CPB volume. I have never used it- so I ask for your opinions on the efficacy as it pertains to ultrafiltration, perioperative cellsaving, and scavenging the residual volume of the ECC […]

HEXMO: Miniaturized ECMO

Click image above to view Source Article Editor’s Note: A submission and link found on Gruppo dei Perfusionisti!!!. Submitted by:  Hiroyuki Kuromitsu This technology is still in the research stages, but seems very workable and sophisticated.  I have no idea about a time table for in-vivo human trials. = = Click image to view entire […]

New Technologies : FerroFluids- Artificial Heart Technology

Click image to view source article Editor’s Note: I got this link from a friend of mine, an extremely talented Operating Room instructor, Paul Landman. “Saw this while reading a news app. Thought you’d find it interesting. Ferrofluid heart mimics human biology to circulate blood.” A new ferrofluid-based artificial heart design seeks to aid transplant […]

Oxygenator Changeout

PROCEDURE FOR IMPLEMENTATION: A.        Equipment Needed: 1.         One (1) new oxygenator 2.         Four (4 – 6) tubing clamps 3.         Sterile heavy scissors or knife blade 4.         Alcohol swabs B.         Procedure for Changing Membrane Oxygenators: 1.         If warm, cool the patient if time permits. 2.         Close the arterial line filter bleed line, turn off the […]

MicroCircuits & Rapping : [Reprint]

MicroCircuits & Rapping (Click Here if you want to skip to a list of posts) In the last 15 months, our institution decided to get aggressive about reducing our transfusion rate, and the numbers of patients that had postoperative bleeding issues. Originally our aim was to reduce the circuit size and use the integrated microcircuits […]

臨床工学技士 : Japanese Scope of Practice ?

Hi, Sorry to email you out of the blues. I like your blog very much. It is very informative and gives me a better insight into the live and work of a Perfusionist. I hope someday I can contribute as a Perfusionist too. I am currently doing a BSc in Biological Sciences and hoping to […]

A Letter to ‘Surfers : The State of the Blog …

A while ago I got an email from a colleague across the pond (the one leading down to the southern hemisphere), a Mr. Martin Gill. If you have followed Circuit Surfers, you will remember Martin as the Australian pediatric perfusionist that did an extraordinary series of posts in the form of a “Live Blog” of […]

A Letter to ‘Surfers : IABP Protocols

= From Greta: Hey Frank How goes it?  Hope all is well in TEXAS!!! A hospital administrator came to my office the other day and wanted to know if the Perfusion society or organization has anything in their by-laws or standard of care practices, about how often a IABP should be managed on the Nursing floor i.e. (daily checks).  I know […]

Clamp Migrations

Priming  (Click Images to Enlarge) Not Quite Primed = = =Clampless … Primed Clamped Out On CPB Off Pump  Next case … Click to Donate Click here to View Gallery Any Donations are for the cost and development of an International Perfusion Art Gallery, Framing, Printing, Matting, and Expenses associated with delivering the Gallery to […]

Career Perfusionist: [6] The Heart-Lung Machine

Perf 101:  The Extracorporeal Circuit Diversion of blood from the operative site, via an extracorporeal circuit (ECC) is necessary to proceed with open heart surgery .  Vascular access leading to the right side of the heart (venous) and ejecting from the left side of the heart (arterial) is shunted from the patient to the heart […]

Take the Leash off: The Wireless VAD

Click Image to View Article I ran across a link of this article on the SUNY FB site. So a big thank you to SUNY 🙂 . “Tetherless” power-transmission technology could radically change LVAD therapy…  By Reed Miller Ft Lauderdale, FL– Engineers have been trying to create a completely implantable ventricular assist device (VAD) that […]

Product Review: Orpheus Perfusion Simulator

Editors Comment: I first saw this simulator discussed in a very fine Live Blog of the 2011 ANZCP Perfusion Conference, forwarded by Mr. Martin Glill, perfusionist  from Australia. I personally haven’t seen it deployed or demonstrated at a conference, because I don’t go to as many perfusion meetings as I would like to. So here […]

Product Review: Medos Pediatric Oxygenators

I saw a question regarding the Medos Pediatric Oxygenator, and thought I would I would lay down some details gleaned form a google search. This is not an endorsement or advertisement, simply some company details and product specifications. Click any image to view the Medos  corporate site.  (It’s in German) Click image to enlarge.

Fiber Optic IABP :

Any Comments or Observations ? – Nooo…  It’s NOT – the “Little Shop of Horrors” Plant (As Editor… I get to do cool stuff like this…) / Regarding Fiber Optic IABP’s … We have migrated completely to fiber optic Intraaortic Balloons. What is your experience with these? Any clinical issues? I have looked for any […]

Anastamotic Devices

A Review of Anastamotic  SVG devices Proximal anastomotic connectors have been developed to facilitate the anastomosis between the saphenous vein graft (SVG) and the ascending aorta without the use of a partially occluding clamp. The rationale for development of such technology was primarily to minimize the potential for embolization of aortic atheromatous debris. In addition, […]

Bi-Caval Dual Lumen Catheter

Have you used a percutaneous venous cannula like this? The AVALONELITE :  Bi-Caval Dual Lumen Catheter (Click image to visit website) We are looking for a percutaneous cannula that transits the internal jugular to the superior vena cava, right atrium, and inferior vena cava. I have looked at this cannula online, but it looks like […]

Devices: Fibrillator

Where Can I find This ? Cardiac Fibrillator: (Click Image to Visit Website) There was a message on Perflist regarding trying to locate a fibrillator.  Now I had seen these messages pop up now and again, so I figured- “why not give it a shot” ? Simple Google thing right?  Typed it in, and voila’ […]

The Joshua Story [1]

A Bridge  to ? A while ago I got a tweet from someone I didn’t know at all… I don’t get a lot of major league support or endorsements from people that visit here, but certainly I have gotten plenty of encouragement. To get a comment like this, from out of the blue was a […]

ABTC Conference: Live Blog

Live Blogging The Autologous Blood Therapy Course (ABTC): (Click on Image to visit ABTC website) Heading down to Jackson, Mississippi… I’ve heard some great things about this course being offered up by Mr.Pat H. Courtney, Jr. LP, RABT (Licensed Perfusionist, Registered Autologous Blood Therapist.) . First of all, Pat’s a nice guy (as well as […]

Mr. Sid Yarrow: Perfusion Pioneer

Perfusion Profiles Mr. Sid Yarrow:  New Zealander :  Perfusion Pioneer  To View All the Profile Series…  Click Here. A Pioneer Passes… Editors Note:  The first part of this story was posted by Tim Willcox, CCP (Australia) on Perflist. I felt it such an inspiring story, that I tried to dig up a little bit more […]

Need Information ASAP on NOVALUNG

Talya Frey to Perflist show details 9:14 AM (15 hours ago) Need Information ASAP on NOVALUNG We have a 10 kg patient with pHTN that our team is interested in using the Novalung device to treat worsening RV function and chronic poor lung function. I am looking for any information regarding useage of this device, […]

HeartMate & HIT

HeartMate XVE :  Explantation in the Setting of Heparin Induced Thrombocytopenia (HIT) Utilizing ACT and TEG Analysis Authored by:   Scott M. Noesges LP, CCP  BAYLOR UNIVERSITY MEDICAL CENTER  DALLAS, TEXAS Scott M. Noesges LP, CCP, offers the community an amazing case study of a case already highly complex in nature, complicated even more so by […]

Failing Oxygenator

Case Report- Failing Oxygenator… Operation: Aortic Valve Replacement, End to End Graft from Aortic Root to Ascending Aorta. Pt. Data 55 years old Gender excluded 71 inches 95 Kilograms 2.15 BSA Baseline Hematocrit- 48% Pertinant Hx: Unremarkable. No coagulopathic issues No antiplatelet regimen Severe AI Mild AS Dilated Root No other issues-  patient appeared to […]

New Technologies

The ROTOFLOW VAD (Maquet) This is the second post regarding VAD technology. These posts are not meant to promote or recommend any particular system over another system.  That is  not what this forum is about. These devices are out there and being used by our peers, so I ask exactly that from you- an honest […]