Abstract
We examined and compared the hemorrhagic factor, pen- and postoperatively, between surgery employing femoro-femoral bypass (using the roller pump), and that by left heart bypass (using the centrifugal pump and a heparine-coated tube). Both of these procedures were administered as extracorporeal circulation in the surgery of the descending thoracic aorta in our department. Out of 38 cases, 28 underwent femoro-femoral bypass (FF group), and in 10 cases, left heart bypass was employed (LH group). As a result, in the FF group, 5 cases (17.9%) showed pen- or postoperative complications; two of the cases succumbed perioperatively because of blood loss and two cases hospital death from intrapulmonary bleeding. In contrast, in the LB group, no fatality has been reported, although intrapulmonary bleeding was observed in 1 case (10.0%). The average amount of postoperative blood loss tended to be lower in the LH group. Moreover, the postoperative minimum platelet count averaged 7.1 × 104/mm3 in the FF group against 12.6 × 104/mm3 in the LH grouip. Thus, the LH group encountered only a mild reduction in platelet count, which we regard as one of the factors which reduced postoperative blood loss. On the basis of these findings, it is our conclusion that the left heart bypass by centrifugal pump is an effective technique which ameliorates fatal pen- and postoperative hemorrhagic complications.
