Nonheparinized partial cardiopulmonary bypass for repair of traumatic aortic rupture

Traumatic aortic rupture requires rapid, definitive repair for optimal outcome, particularly with respect to distal neurologic function. Over the past 10 years, the R Adams Cowley Shock Trauma Center of the University of Maryland has used partial cardiopulmonary bypass without systemic heparization exclusively for all repairs of the descending aorta. A heparin-bonded circuit allows for controlled distal perfusion and obviates the need for heparinization. Excellent outcome with minimal morbidity has been achieved using this technique. Our protocol and perfusion apparatus are discussed within.