The Journal of extra-corporeal technology
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J Extra Corpor Technol · Mar 2002
Vacuum-assisted venous drainage: to air or not to air, that is the question. Has the bubble burst?
Assisted venous drainage is a recent development in cardiopulmonary bypass (CPB) and was introduced to overcome limitations in achieving adequate blood flow through small diameter cannulas used in minimally invasive surgery. The more common application, vacuum assisted venous drainage (VAVD) is now widely used in both adult and pediatric CPB. During a clinical investigation into pharmacological cerebral protection at Green Lane Hospital, we repeatedly observed evidence of emboli in the right common carotid artery following both entrainment of air into the venous line, and also, reductions in the blood level of the hard-shell venous reservior. ⋯ While VAVD may be efficacious in certain scenarios, a thorough understanding of its influence on CPB is essential. Advantages must be balanced against potential hazards. The safe use of VAVD necessitates refinement of perfusion techniques, judicious choice of application, and further development of the CPB circuit.