Comparative Effectiveness of Unilateral vs. Bilateral Pulmonary Collapse in Cardiac De-airing

Lund University

Status: Completed

Conditions: Brain Ischemia; Reduction of Cerebral Air Emboli

Treatments: Procedure: Bilateral Open Pleurae; Procedure: Right Pleura Open

Study type: Interventional

Funder types: Other

Identifiers

NCT02119871

BKML-004

Details and patient eligibility

About

To compare the effectiveness of unilateral pulmonary collapse (right lung) to bilateral pulmonary collapse for cardiac de-airing in open left-sided heart surgery.

Full description

Effective removal of air from the heart before termination of cardiopulmonary bypass (CPB) is vital in open left heart surgery. Bilateral collapse of the lungs during cardiopulmonary bypass decreases the duration of the de-airing procedure, decreases residual air emboli monitored on Trans-esophageal Echocardiography (TEE) and decreases gaseous cerebral microemboli (MES) monitored by Trans-cranial Echo-Doppler (TCD) when compared to expanded lungs during (CPB). Induced pulmonary collapse by opening of the pleura and disconnection of the patient from the ventilator during CPB decreases the amount of air that can enter the pulmonary veins. Not all surgeons wish to induce lung collapse from fraught that it might lead to pulmonary ischemia or infection. It is unknown whether collapse of only the right lung is as effective as collapse of both lungs.

Enrollment: 20 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aortic valve pathology requiring surgery.

Exclusion criteria

• Prior thoracic surgery,
• Severe chronic obstructive pulmonary disease and/or
• Emphysema.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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20 participants in 2 patient groups

Bilateral Open Pleurae

Experimental group

Description:

Bilateral open pleurae and usage of right pulmonary vein drainage

Treatment:

Procedure: Bilateral Open Pleurae

Right pleura open

Active Comparator group

Description:

Opening of right pleura and usage of left ventricular apical drainage.

Treatment:

Procedure: Right Pleura Open