Heparin-bonded circuits without a cardiotomy: a description of a minimally invasive technique of cardiopulmonary bypass.

The deleterious effects of cardiotomy suction have been well recognized and well documented for some time. The use of cardiotomy suction results in the exposure of blood to the defoaming sock, aspiration of stagnant pericardial blood into the systemic circulation, and the entrainment of both fatty and gaseous microemboli. The purpose of this paper is to describe a technique using heparin-bonded cardiopulmonary circuits (HBCs) without the use of a cardiotomy reservoir or cardiotomy suction. Our group has previously demonstrated improved clinical outcomes using HBCs and a low-dose anti-coagulation protocol. It is our goal to further improve clinical outcomes and further attenuate the deleterious effects of cardiopulmonary bypass by eliminating the potential complications attributed to the use of cardiotomy suction.