A Locum’s ScrapBook: Modifying the ECC for Antegrade Cerebral Protection

Editor’s Note: To view the entire “Locum’s ScrapBook” series- click here My life is Family First and then Perfusion.  I take BOTH very seriously. I switched from staff perfusionist to becoming a Locum’s traveler to make sure my kids and family would have a solid place to call home.  I travel because it puts me in […]

A Locum’s ScrapBook: A Cool ECC Modification

“These shunts were put in place to allow for passive recirculation of the Qust MPS Microplegia system, so that an unexpected negative pressure will NOT deprime the MPS system.” Editor’s Note: To view the entire “Locum’s ScrapBook” series- click here My life is Family First and then Perfusion.  I switched from staff perfusionist to becoming a […]

Welcome to HIPEC!

2 Cone Heads 🙂 Editor’s Note: I had an opportunity to assist and learn how to do a HIPEC procedure.  This was an extraordinary experience, and this perfusion group in Iowa should definitely be recognized for the advanced perfusion techniques they do routinely, that many of us have never had the opportunity to be a part […]

Synchronized vs. Unsynchronized Cardioversion

Courtesy of ACLS-Algotithms.com  (Click image to view site) Editor’s Note: It’s funny how you can go an entire career doing something (CPB) and hear the same thing every day, but actually not evaluate what it means.  Yes, I have taken ACLS and studied the electrophysiology of the heart. So anyway, we have just taken off the […]

Cairo, Egypt: Case Study: AVR with Antiphospholipid Syndrome

Editor’s Note: I saw this post of Ramy’s FB page (or maybe one of the perfusion groups on FB) and reached out to Ramy to submit this as a case study.  He has graciously forwarded the case study and I thank you Ramy. Feel free to leave comments in the comments section- Happy Saturday 🙂 […]

Pressors; Q; or Volume?

Editor’s Note: Well I was surfing the perfusio.com FB perfusion group, when I came across a continuing dialogue on when and why to adjust pressure using flow, vasopressors, or volume… So it seemed to be a pretty advanced thread- and I thought I would share it to see if anyone else wanted to join in? Pressors; […]

Plz Donate: Intervention Doesn’t Stop AFTER the Operation…

“This would make the realistic GoFundMe goal approximately $10,800- a sum that represents less than the purchase price of a used car…” Click Image Above to Donate 🙂 Editor’s Note: I was checking FB the other day, and spotted a compelling story on the page of a long distance friend (as well as colleague on this […]

Using Occlusive Foley Catheters to Control Excessive Tumor-Related Bleeding

Dr.Harinder Singh Bedi = = The lowly Foley to the rescue – It was the 4th case . A meticulous  total arterial off pump bypass and and two hectic mitral and tricuspid valve repairs – the 2nd had required some extra  time as it was a young lad and I wanted to avoid a valve […]

From Italy [ 7 ] Reshaping the Heart

Editor’s Note: Once again, just checking early morning news and chatter on Facebook, and another interesting link rears it’s head.   I found this article on an Italian perfusion FB page by CardioPeople- an Italian resource- very well organized, and very professional. Link:  https://www.facebook.com/universita.campobasso They provided an English version of the above cited topic- so […]

From Italy [ 6 ] Mitral Prosthesis, Implantation on the Beating Heart

Editor’s Note: Once again, just checking early morning news and chatter on Facebook, and another interesting link rears it’s head.   I found this article on an Italian perfusion FB page by CardioPeople- an Italian resource- very well organized, and very professional.  http://www.cardiopeople-network.com/social/index.php?do=%2Fpages%2F10%2F They provided an English version of the above cited topic- so I […]

CPB Techniques for ESRD/Hemodyalisis on Pt Awaiting Renal TX

Dr.Harinder Singh Bedi = = I have a 56 year old patient in ESRD on hemodialysis with a left radial AV fistula . He was being planned for renal transplant and was discovered to have critical and diffuse CAD- so being taken up for CABG . Plan so far : 1. avoid LIMA because of […]

The First Ever Artificial Heart Transplantation in Azerbaijan

Editor’s Note: A FB friend and colleague of mine, Cuneyt Imamoglu, from Baku, Azerbaijan, shared the story below of the ground breaking procedure performed for the first time in Azerbaijan. Cuneyt is very active on-line promoting perfusion dialogue and education. Thank you for sharing this Cuneyt 🙂 Frank   The first ever artificial heart transplantation […]

Femoral Cannulation for CPB: Tips and Discussion…

Editors Note: I got this email today: “Respected Sir / Mam, This is Shahriar from Bangladesh. I am interested to know about femoral bypass technique.  Awaiting for your kind suggestion. Regards, Towfiq Shahriar Islam Khan, Perfusionist IBN SINA Hospital (Cardiac Centre) Bangladesh” Hence, the following article. Please feel free to add suggestions or advise as […]

H1N1- ARDS- & ECMO (Current Literature)

Editors Note: A big thank you to Marianne Veir Pilger, CCP, and her colleague John @ Meriter Hospital in Madison, Wisconsin for helping out so quickly and hooking us up with the below listed articles on ECMO management for ARDS and H1N1. This is something we are all facing- so I hope it helps. Again- […]

CNS & CPB

CNS & CPB The major postoperative neurological complication associated with open-heart surgery and cardiopulmonary bypass is stroke, which is defined as a sudden onset of a focal deficit of the central nervous system lasting longer than 24 hours.  While this clinical finding occurs in approximately 1-5% of cardiac surgery patients, 70% of cerebrovascular sequelae occur […]

Letters From the Philippines: Improving O2 Transfer?

Editor’s Note: Hi Guys, I got this letter from a Filipino  perfusionist via FaceBook.  If any of you have any engineering insights into the mechanics of increasing Oxygenator surface area for improving O2/CO2 exchange , can you send replies to Kevin Tabamo’s FB page? Thanks ! = = 🙂 Frank Click image to respond directly […]

Letters From Pakistan: Questions on the CardioHelp System

Click image to view manufacturer’s information on this product- Editor’s Note: Hi Guys, I got this letter from a Pakistani perfusionist via LinkedIn.  If any of you have any Experience using the CardioHelp System, can you send replies here to ‘Surfers? I have no experience with the device, so it would be inappropriate for me […]

ECMO Research Study : This is a PAID Survey…

Editor’s Note: I spoke with this gentleman on the phone for a bit.  He was a well spoken and forthright individual.  This survey is important for our profession in terms of evaluating new ECMO principals and applications. Please respond to his email or phone number if you are interested in participating in the survey/study 🙂 […]

Cold Agglutinins

Literature: Click image to view source article Cold Agglutinins in Cardiac Surgery: Management of Myocardial Protection and Cardiopulmonary Bypass CAs are autoantibodies to RBC antigens [3], which can causesystemic thrombosis and hemolysis. The cause of these CAs maybe primary/idiopathic, or more commonly, secondary to an infectiveprocess (eg, mycoplasma, human immunodeficiency virus) or alymphoproliferative disorder [2]. […]

Around the (Distant) Pump Room by Martin Gill, CCP.

An AMAZING Perfusion Publication ! (Contact Martin on how to Subscribe) Media Journalism by… Martin Gill: Perfusionist Editor (former), ANCZP Gazette email for subscription: martin.gill@health.nsw.gov.au (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note: Martin Gill is a gifted writer and supporter of perfusion international relations and improving perfusion practice- wherever it may be. He has […]

A Quick Guide to Changing Out the Terumo FX15 / 25 Oxygenator

Editor’s Note: I had an early Op-Cab and was looking at a primed circuit that I had set up the day before- for a case that was also an Op-Cab.  It was primed with Normal Saline, no meds, and would have been fine to use on our patient today. I decided to go ahead and […]

Ventricular Hypertrophy & Perfusion

LVH :  Photo by:  Srinivas Rao @ Gruppo dei Perfusionisti!!! Ventricular Hypertrophy & Perfusion Subendocardial Q Determinants While subendocardial and sub-epicardial layers have the same determinants for blood flow, subendocardial layers are at greater risk from ischemia and infarction.  The deeper subendocardium is subjected to greater wall tension which then expresses as a metabolic requirement […]

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 […]

Sickle Cell Anemia & CPB

I.    DESCRIPTION: Sickle Cell hemoglobinopathy is a single gene recessive disorder that involves an abnormality of the hemoglobin (Hgb) molecule.  This disorder causes the red cell to sickle under certain circumstances.  A sickled cell cannot undergo normal respiratory functions and they interfere with normal blood circulation. Sickle cell disease is genetic and a patient may […]

Jehovah’s Witness & Open Heart Bypass

Jehova’s Winesses:  A Background Jehovah’s Witnesses believe that the Bible prohibits ingesting blood and that Christians should therefore not accept blood transfusions or donate or store their own blood for transfusion.[1] Watch Tower Society publications teach that the Witnesses’ refusal of transfusions of whole blood or its four primary components—red cells, white cells, platelets and […]

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 […]

Deep Hypothermia: Antegrade & Retrograde Cerebral Perfusion

Editor’s Note: Deep Hypothermic Circulatory Arrest (DHCA), is a concept discussed here in this forum, as well as a significant perfusion event when it comes to the horizon. Obviously an issue for aortic dissections, transections, or congenital malformations that require a surgical approach and repair that can only be accomplished by intermittent or momentary cessation […]

Deep Hypothermia: Rapid Cooling & Nitroglycerine

Editor’s Note: Deep Hypothermic Circulatory Arrest (DHCA), is a concept discussed here in this forum, as well as a significant perfusion event when it comes to the horizon. Obviously an issue for aortic dissections, transections, or congenital malformations that require a surgical approach and repair that can only be accomplished by intermittent or momentary cessation […]

The “Hot Shot” : A Layman’s Approach to Myocardial Protection

A Salient Point from a Perfusionist: “I will give one good example of how a warm/hot shot worked for us. We finished up a normal 4 banger and before doing the proximals with the cross clamp on we routinely give a short hot shot, actually its room temperature shot, but I digress. The clamp was […]

Live Blog: Uluru ! 2012 [Wrap-Up]

Uluru is sacred to the Anangu, the Aboriginal people of the area. The area around the formation is home to a plethora of springs, waterholes, rock caves and ancient paintings. Uluru is listed as a World Heritage Site. Media Journalism by… Martin Gill: Perfusionist Editor, ANCZP Gazette (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note: […]

Live Blog: Uluru ! 2012 [Saturday Afternoon]

Uluru is sacred to the Anangu, the Aboriginal people of the area. The area around the formation is home to a plethora of springs, waterholes, rock caves and ancient paintings. Uluru is listed as a World Heritage Site. Media Journalism by… Martin Gill: Perfusionist Editor, ANCZP Gazette (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note: […]

Live Blog: Uluru ! 2012 [Saturday Morning]

Uluru is sacred to the Anangu, the Aboriginal people of the area. The area around the formation is home to a plethora of springs, waterholes, rock caves and ancient paintings. Uluru is listed as a World Heritage Site. Media Journalism by… Martin Gill: Perfusionist Editor, ANCZP Gazette (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note: […]

Live Blog: Uluru ! 2012 [Friday]

Uluru is sacred to the Anangu, the Aboriginal people of the area. The area around the formation is home to a plethora of springs, waterholes, rock caves and ancient paintings. Uluru is listed as a World Heritage Site. Media Journalism by… Martin Gill: Perfusionist Editor, ANCZP Gazette (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note: […]

Live Blog: Uluru ! 2012 [Thursday]

Uluru is sacred to the Anangu, the Aboriginal people of the area. The area around the formation is home to a plethora of springs, waterholes, rock caves and ancient paintings. Uluru is listed as a World Heritage Site. Media Journalism by… Martin Gill: Perfusionist Editor, ANCZP Gazette (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note: […]

Live Blog: Uluru ! 2012 [Wednesday]

Uluru is sacred to the Anangu, the Aboriginal people of the area. The area around the formation is home to a plethora of springs, waterholes, rock caves and ancient paintings. Uluru is listed as a World Heritage Site. Media Journalism by… Martin Gill: Perfusionist Editor, ANCZP Gazette (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note: […]

From Italy [ 5 ] Transcatheter Aortic Valve Implantation

Editor’s Note: Once again, just checking early morning news and chatter on Facebook, and another interesting video link rears it’s head.  This video can be found below- or on the FB group Care of heart  founded by Manoj Sharma  an Indian perfusionist that I have interacted with occasionally online. Now this video is in Italian- so if […]

To India: Long Distance Advice…

Editor’s Note: I was just kicking around Face Book when I got an online message from somewhere in India (I believe). Let me clarify 1st-  that I DO NOT represent myself or this blog as a Perfusion Help Line- but I do advocate that we use new media to facilitate situations exactly like this. So […]

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 […]

The Role of Nitric Oxide in Myocardial Ischemia / Reperfusion

(Click above to view source article) ABSTRACT = Objective: The role of nitric oxide (NO) in myocardial ischemia/reperfusion is controversial. While some studies have shown cardioprotective effects of NO, others suggested that increased myocardial NO release secondary to ischemia may contribute to reperfusion injury. However, the impact of cardioplegia-induced myocardial ischemia/reperfusion on the activity of […]

Letters From Italy: Thesis Topic Suggestions?

Elisabetta Maio Hi Guys, I got this letter from a young Italian perfusion student.  She is looking for ideas for her thesis. Do you all have any suggestions? There are a million possibilities.  If any of you have any ideas- please submit them or leave Elisabetta a message in the comments section? Thanks ! = […]

ECMOjo : Online ECMO Simulator [Reprint]

(Click Image Above to View Site and Test Drive The Simulator) I was surfing the net (actually I was looking at the newest perfusion website I have become familiar with- a very cool site–  perfusione.net ) when I happened across this ECMO simulator and decided to take a look at it. Manufactures and Product Insert […]

A Global Foum ? Yeah ! We Can Do It !

A Picture of the Sun… I would like a Global Forum. It is necessary and far past due. My hope is that eventually, this blog will be considered a resource for all of us. I need help. I need writers and opinions from all over the globe. So please tell your friends if they are […]

Live Blog: ANZCP Down Under [3]

Media Journalism by… Martin Gill: Perfusionist (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note:  This opportunity is provided by the efforts of, Mr. Martin Gill, perfusionist, who is attending this meeting in Sydney. The intention here @ CircuitSurfers is to offer up a library of these types of objective POV’s (Points of View) to highlight […]

Live Blog: ANZCP Down Under [2]

Media Journalism by… Martin Gill: Perfusionist (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note:  This opportunity is provided by the efforts of, Mr. Martin Gill, perfusionist, who is attending this meeting in Sydney. The intention here @ CircuitSurfers is to offer up a library of these types of objective POV’s (Points of View) to highlight […]

Live Blog: ANZCP Down Under [1]

Media Journalism by… Martin Gill: Perfusionist (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note:  This opportunity is provided by the efforts of, Mr. Martin Gill, perfusionist, who is attending this meeting in Sydney. The intention here @ CircuitSurfers is to offer up a library of these types of objective POV’s (Points of View) to highlight […]

Live Blog: ANZCP Down Under [0]

Media Journalism by… Martin Gill: Perfusionist (Children’s Hospital at Westmead, Sydney Australia) Editor’s Note:  This opportunity is provided by the efforts of, Mr. Martin Gill, perfusionist, who is attending this meeting in Sydney. Thank you sir for your effort & contribution. The intention here @ CircuitSurfers is to offer up a library of these types […]