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Innovative Miniature Heart-Lung Machine for Infants

Summary of “A Table Mounted Cardiopulmonary Bypass System for Pediatric Cardiac Surgery”

  • An innovative miniature heart-lung machine, placed close to a patient being operated during surgery to repair congenital heart defects, helps eliminate the need for blood transfusions.
  • Khanh H. Nguyen, MD, Chief of Pediatric Cardiac Surgery at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), has been instrumental in developing this unprecedented system, which manages heart and lung functions during heart surgery.
  • This system decreases the need to prime blood with saline, which typically is a requirement of traditional open-heart surgery, as it flows through the bypass system’s tubes. That means that the child’s blood isn’t diluted as much. This new system also avoids decreasing the red blood cell count, a critical vital sign.

This study, published in The Annals of Thoracic Surgery, details how an innovative miniature heart-lung machine, strategically placed on an Operating Room surgical table close to a patient, enhances infant health during surgery to repair congenital heart defects.

Khanh H. Nguyen, MD, Chief of Pediatric Cardiac Surgery at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), has been instrumental in developing this unprecedented cardiopulmonary-bypass system. It is one of several transformative techniques optimized during pediatric cardiac surgery by Dr. Nguyen and Maria Fareri Children’s Hospital’s highly skilled and experienced team. For appointments or referrals, please call 914.493.8793.

Heart-lung machines manage functions of the heart and lungs during cardiac surgery, maintaining blood flow and oxygen level. While a conventional heart-lung machine and its pediatric version are positioned on a wheeled console, Dr. Nguyen and his team use a miniaturized system mounted on the operating table. Its proximity to the patient’s heart decreases the need to place blood in the bypass system’s tubes. Less circulating volume results in less dilution of infants’ small volume of blood. In addition, dilution decreases the red-blood cell count, a critical parameter. As such, the miniaturized heart-lung machine helps reduce and even eliminate the requirement for blood transfusion. Its small circuit also minimizes systemic inflammation that manifests as general swelling and fluid accumulation, side effects of an open-heart operation. That facilitates a quicker return to normal breathing and organ function. The reduction or avoidance of using donated blood also reduces well-known potential complications of blood transfusion. Initial clinical data have shown that the miniature heart-lung system is safe, reliable and reproducible.

Overall, this revolutionary approach significantly advances pediatric cardiac surgery. It improves overall outcomes and is an essential tool to facilitate bloodless surgery in very small infants. As prenatal diagnosis of congenital heart disease has become common practice, operations now can be planned even before the child is born. The Maria Fareri Children’s Hospital pediatric cardiac surgery team is poised to use this miniaturized bypass machine for those newborns, and if necessary, use the child’s own cord blood to prepare the machine’s circuit. This approach can potentially complete the entire surgical treatment of the baby’s heart condition without use of donated blood.

The Annals of Thoracic Surgery is a medical journal covering pulmonary diseases and surgery. It is the official journal of the Society of Thoracic Surgeons and the Southern Thoracic Surgical Association. This study was published in September 2018.

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