OBJECTIVES Neurological impairment occurs in up to 25% of infants undergoing cardiopulmonary bypass with or without circulatory arrest. Potential causes include alterations in cerebral blood flow, hypoxia and embolisation. During cardiopulmonary bypass, arterial oxygen tension is maintained at levels which under normal conditions cause cerebral vasoconstriction; this is a potential mechanism fo...

Extracranial-intracranial arterial bypass was frequently utilized in the 1970s and early 1980s to treat patients with atherosclerotic occlusive carotid arterial lesions not amenable to extracranial arterial revascularization procedures. After a large randomized trial reported in 1985 that there was no benefit of surgery in these patients, the procedure was generally abandoned as a treatment for...

Arterial line filters are considered by many as an essential safety measure inside a cardiopulmonary bypass circuit. There is no doubt that this was true during the bubble oxygenator era, but we can question whether the existing arterial line filter design and positioning of the filter are still optimal seeing the tremendous progress in cardiopulmonary bypass circuit components. This overview g...

For cardiopulmonary bypass during open-heart surgery we use a bubble oxygenator and a technique of haemodilution and moderate hypothermia. During the course of routine perfusion we have observed arterial desaturation in a number of patients and in five patients the desaturation was marked (SaO2<85%)'. The low arterial oxygen saturations occurred mainly in the rewarming period. This report is of...

Surgical coronary bypass has evolved continually, and recent developments favor performing coronary grafts with all-arterial conduits in order to obtain better long-term graft patencies. With bilateral internal mammary artery grafts and both radial arteries, four excellent arterial conduits exist for revascularization of the majority of multivessel disease patients, including those with valve d...

OBJECTIVE To report on the original surgical management of a patient with severe trauma of both legs involving anastomosis of an omentum free flap with an emergency vascular bypass. METHODS After stabilization of the knee with an external fixator, a femoral-tibial bypass graft was performed to revascularize the leg with the contralateral great saphenous vein. Ten days later, an omentum free f...

The arterial filter is an integral part of bypass circuitry. When introduced, manufacturers suggested a bypass loop for retrograde priming and de-airing, and for uninterrupted blood flow in case of malfunction. Practice has shown antegrade priming and de-airing is possible. This questions the necessity of the loop and presents the question-what occurs in the loop during bypass? After obtaining ...