Application of vacuum assisted venous drainage in heart surgeries for newborns

To explore the role of cardiopulmonary bypass (CPB) with vacuum assisted venous drainage(VAVD)in the management of newborns with congenital heart diseases.

Total 15 newborns with congenital heart diseases (11 males and 4 females)underwent heart operations. Their age ranged from 2 days to 28 days [mean:(15.67 ± 2.22)days], and their body weight from 2.3 kg to 4.8 kg [mean: (3.75 ± 0.19)kg]. Sternal median incision was made to establish CPB,during which VAVD was applied for all the newborns.

In these 15 newborns,the mean CPB time was from 50 minutes to 343 minutes [mean:(170.3 ± 26.6)minutes], and the mean aortic clamping time ranged from 20 minutes to 172 minutes [mean:(85.8 ± 14.6)minutes]. No macroscopic hematuria, inadequate drainage, or cannulation vena cava difficulty was observed during the procedures. All the newborns were successfully weaned from the machine. No neurological complication due to micro air embolus caused by negative pressure was noted. No vena cava infarction, thrombosis, or other complication was reported after the surgery, although one patient died after the surgery and another patient was discharged upon its family's own decision.

VAVD is a safe, simple, and cost-effective technique. Appropriate negative pressure can the resistance during thinner venous intubation and thus speed up blood drainage,provide adequate perfusion flow,and reduce the pre-filling volume.