Weaning from cardiopulmonary bypass, decannulation, and closure
ABSTRACT
In 1952, John Gibbon performed the first successful cardiac procedure using cardiopulmonary bypass, which turned out to be one of the most important clinical advances of that year. Cardiopulmonary bypass has also been described as “One of the most impressive evidences of the role of investigative surgery in the history of medicine in the persevering efforts of Dr. Gibbon for more than 20 years, which finally culminated in a practical heart-lung machine,” at the first John H. Gibbon, Jr, Lecture at the annual meeting of the American College of Surgeons [1]. Due to the subsequent advancement of cardiopulmonary bypass, many patients with complex heart disease requiring surgical care undergo cardiac surgery while the other organs remain adequately oxygenated and perfused.
INTRODUCTION
Although thoracotomy or newer, less-invasive options such as peripheral cannulation are being used more frequently for minimally invasive cardiac surgery, surgical access through a median sternotomy and central cannulation remain the cornerstones of cardiac surgery and residency training. It is of utmost importance to wean the patient properly from cardiopulmonary bypass (CPB). This video tutorial discusses weaning the patient from CPB, decannulation, and closure of the sternotomy, and describes the safeguards and pitfalls of weaning from CPB.