Description of the Minimized Extracorporeal Circuit to perform Haematic Antegrade Repriming in Cardiopulmonary Bypass

Introduction: cardiac surgery is continuosly evolving towards a less invasive procedures and different perfusion techniques are also being studied to enhance the results. The aim of this study is to propose a standardized minimized extracorporeal circuit (MiECC) design to guarantee a fix low contact surface and haemodilution when the haematic antegrade repriming (HAR) is being applied. Materials and Methods: after a review of the current evidence a minimized circuit of 3/8 inch diameter was proposed and approved by our cardiac surgery team. Results: The initial dynamic priming of the circuit is lower than 1000ml. After HAR maneuvres, the haemodilution is reduced to 300ml of crystalloid priming. Discussion: The standardization of the circuit reduces errors, offers continuity between centres and savings. The basis of HAR are the detailed and reproducibile measures that could exceed the benefits of the isolated effect of reducing the circuit, applying vacuum to increase the drainage or retrogradely repriming it with blood. As a differencing factor, the standardization and detailing of the procedure offers reproducible results that should be assessed. Conclusion: Detailing the MiECC circuit used during HAR is a differencing feature that increases the replicability of the procedure reducing errors and the impact of the cardiopulmonary bypass.