Medtronic Academia Trainingscenter
Training is designed for surgeons, anesthetists and perfusionists to obtain or expand knowledge of Minimized ECC Systems, techniques and troubleshooting.
The severe inflammatory reaction due to the contact of human blood with non-physiologic surfaces and with room air , along with the recirculation of fluids aspirated from the mediastinum, represent the major causes of post-operative morbidity in patient undergoing Extracorporeal Circulation (ECC). The availability of new, more biocompatible coating materials in conjunction with a mini bypass system as well as centrifugal pumps has significantly reduced the incidence of damages related to ECC. Nevertheless some problems still remain open. The idea of using more physiologic membranes for oxygenators , centrifugal pumps, closed circuits and coated tubing, along with the avoidance of recirculation of activated pericardial blood , has resulted in the development of our of the so-called 'Mini-ECC Systems.' Another aspect in helping reducing the use of foreign blood products is the use of cardiosmart and optimized heparin/protamin titration. The term 'Mini' relates to another important feature of these circuits, that is the possibility of priming the system with low amount of fluids. By reducing the hemodilution, the need for patient transfusion is eventually minimized and or deleterious effects of Cardiopulmonary Bypass are reduced. At the Inselspital, Bern , Switzerland, more than 1200 open-heart procedures per year are performed of which 600 with a mini-bypass system. Our experience with open heart surgery is in our practice in the last 15 years, and it has been successfully employed so far in more than 15,000 cases. Our experience with the Mini system is since 2002 and involved more than 6000 cases.