Transition from Hemochron Response to Hemochron Signature Elite Activated Clotting Time Devices in a Congenital Cardiac Surgery Practice.

Heparin is the primary anticoagulant used during cardiac surgery to prevent thrombosis due to cardiopulmonary bypass (CPB)-related activation of the hemostatic system. The efficacy of heparin in the operating room is generally determined by activated clotting time (ACT) point-of-care tests performed throughout the procedure. In an effort to transition to the Hemochron Elite which requires approximately 1/10th the sampling volume of blood, we conducted a prospective study in 260 pediatric patients undergoing CPB.

A red cell preservation strategy reduces postoperative transfusions in pediatric heart surgery patients.

Background: Blood transfusion has well-documented adverse effects. As part of a blood conservation initiative at our center, we began routine use of cell saver for all congenital heart surgery performed on cardiopulmonary bypass since 2014.

Aims: This study aimed to compare transfusion rates prior to, and in the first and second year after this initiative.

A single-center experience with luminal venous cannulae obstruction caused by clot formation during bypass.

Our institution experienced two bypass cases from January through December 2011 in which venous return was significantly variable and at times poor. Luminal clot formation in the venous cannulae was found in each case postbypass. These events were captured and monitored through our institution's Non-Routine Event Reporting Program and eventually reported to the Food and Drug Administration (FDA).

Massive air embolism in a Fontan patient.

Most institutions performing cardiopulmonary bypass for congenital heart disease patients use an integrated hard shell cardiotomy and venous reservoir attached to an oxygenator. It is of paramount importance that the integrated reservoir be vented so as not to cause pressurization. A pressurized sealed cardiotomy has been reported to occur secondary to issues with vacuum assisted venous drainage systems as well as improper venting in general.

Neurodevelopmental outcomes after biventricular repair of congenital heart defects.

Objective: This study was undertaken to assess neurodevelopment of children after biventricular repair of congenital heart defects.

Methods: Full-scale, performance, and verbal IQs of 69 patients who had undergone biventricular repair were assessed at 5 years of age with the Wechsler Preschool and Primary Scales of Intelligence-Revised. The Wide Range Assessment of Visual-Motor Abilities was used to measure visual-motor skills.