Use of Two Parallel Oxygenators in a Very Large Patient (2.76 m2) for an Acute “A” Dissecting Aortic Aneurysm Repair
Vladimír Lonský,
Jiří Manďák,
Jaroslav Kubíček,
Martin Volt,
Egon Procházka,
Jan Dominik
Affiliations
Vladimír Lonský
Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Department of Cardiac Surgery, Hradec Králové, Czech Republic
Jiří Manďák
Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Department of Cardiac Surgery, Hradec Králové, Czech Republic
Jaroslav Kubíček
Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Department of Cardiac Surgery, Hradec Králové, Czech Republic
Martin Volt
Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Department of Cardiac Surgery, Hradec Králové, Czech Republic
Egon Procházka
Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Department of Cardiac Surgery, Hradec Králové, Czech Republic
Jan Dominik
Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Department of Cardiac Surgery, Hradec Králové, Czech Republic
The very large patient (weight 142 kg, height 197 cm, body surface 2.76 m2) was referred to acute operation with dissecting type A ascending aortic aneurysm. The calculated blood flow was 6.63 l/min. To anticipate potential difficulties with perfusion and oxygenation two oxygenators connected in parallel were incorporated into the circuit. Bentall procedure with ACB to the RCA was performed. The perfusion was uneventful. Bypass time was 259 minutes, cross – clamp time 141 minutes, circulatory arrest 7 minutes. The highest oxygenators gas flow was 2.6 l/min with maximum FiO2 0.42. The use of two in parallel connected oxygenators is a very effective, easy and safe method in such extreme perfusions, offering to the perfusionist a great reserve of oxygenator output.