Assisted venous drainage cardiopulmonary bypass in congenital heart surgery

Background. A novel active venous drainage perfusion circuit was designed t o achieve effective venous return through small venous cannulas. The effica cy and safety of this new system was investigated and compared with a conve ntional gravity drainage system. Methods. Four hundred consecutive patients undergoing open heart repair of congenital heart lesions by one surgeon were studied. The first 200 patient s were supported by gravity drainage and the next 200 patients were support ed by assisted venous drainage. No patient in the time period was excluded from the study. Results. The two groups did not differ significantly in weight, bypass time , or cross-clamp time. Priming volumes were less in the assisted group than in the gravity group (576 +/- 232 mi, versus 693 +/- 221 mi,, p < 0.001). Venous cannula size was smaller in the assisted group when compared with th e gravity group (33.2F +/- 7.4F versus 38.5F +/- 7.1F, p < 0.001). There wa s a trend to lower operative mortality in the assisted drainage group (5 of 200, 2.5% versus 11 of 200, 5.5%; p = 0.10). Hospital stay and pulmonary, infectious, and neurologic complications were comparable in both groups. Ca rdiac complications were less common in the assisted group than in gravity group (22 of 200, 11% versus 38 of 200, 19%; p = 0.017). Hematologic compli cations were less common in the assisted group than the gravity group (6 of 200, 3% versus 19 of 200, 9.5%; p < 0.01). Conclusions. These findings suggest that assisted venous drainage is safe i n congenital heart operations and facilitates the use of smaller venous can nulas. <(c)> 2001 by The Society of Thoracic Surgeons.