Document Type : Original Article
Authors
1
Division of Thoracic and Cardiovascular surgery, Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Nigeria
2
Department of Anaesthesia, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
3
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Ilorin Teaching Hospital, Nigeria
4
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
5
Cardiology unit, Department of Pediatrics and Child health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
6
Cardiology unit, Department of Medicine, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
7
Department of Haematology and Blood Transfusion, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
8
Nephrology unit, Department of Pediatrics and Child health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
9
Department of Radiology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
Abstract
Abstract
Background: Cardiopulmonary bypass (CPB) allows the patient’s heart and lungs to be temporarily devoid of circulation, with respiratory and cardiac activity suspended so that intricate cardiac, vascular, or thoracic surgery can be performed in a safe and controlled environment. Perfusion practice in Nigeria is a relatively new emerging field owing to the slow development of cardiac surgery programs in the country. It is therefore necessary to document and establish scientific, evidence-based protocols that are unique to our environment.
Objectives: To describe the management of patients on CPB (without the use of a cardioplaegia heat exchanger) at our hospital.
Patients and Methods: This was a cross-sectional study from a prospectively collected clinical database of patients operated at our hospital for intra-cardiac defects utilizing cardiopulmonary bypass over a period of 2 years between 2015 and 2017.
Results: A total of nine (9) patients who were operated on for intra-cardiac defects at UITH between the years 2015 and 2017, were placed on CPB. Oxygenated blood was added to the cardioplaegia solution in a ratio of two parts crystalloid to one part fully oxygenated patient whole blood (obtained from the bypass circuit). No cardiolplaegia heat exchanger and delivery system was used for these surgeries. We employed continuous conventional ultrafiltration during CPB. Surgeries were done under mild to moderate hypothermia. There were 8 long-term survivors with one mortality.
Conclusion: We conclude that cardiopulmonary bypass can be safely conducted in a resource challenged facility with some modifications to the conventional technique.
Keywords
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