Modified Extracorporeal Circulation (mECC) for enhanced blood conservation in thoracoabdominal aortic surgery: A single-center experience


SARICAOĞLU M. C., Akça F., ÖZÇINAR E., HASDE A. İ., DİKMEN N., Durmaz O., ...Daha Fazla

Perfusion (United Kingdom), 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1177/02676591261446469
  • Dergi Adı: Perfusion (United Kingdom)
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Anahtar Kelimeler: aortic repair, blood conservation, modified extracorporeal circulation, organ perfusion, thoracoabdominal aortic aneurysm
  • Ankara Üniversitesi Adresli: Evet

Özet

Background: Thoracoabdominal aortic aneurysm (TAAA) repair is associated with significant risks of blood loss and organ ischemia. This study evaluates the efficacy of a novel, modified Extracorporeal Circulation (mECC) circuit system designed to enhance blood conservation and selective organ perfusion during open TAAA repair. Methods: In this retrospective analysis, 7 patients underwent open thoracoabdominal aortic repair between January 2022 and October 2024 using a modified extracorporeal circulation system. The system incorporated integrated roller pumps for selective visceral and renal perfusion, a centrifugal pump, and an integrated autotransfusion system reservoir to optimize hemodynamic control and minimize allogeneic blood transfusion. Demographic data, intraoperative parameters, transfusion requirements, and postoperative outcomes were assessed. Results: The cohort consisted of 7 patients (57.1% male; mean age 54.4 ± 15.0 years). Crawford type I repair was performed in 71.4% of cases. The mean ECC duration was 104.4 ± 16.8 min, and mean aortic clamp time was 72.0 ± 18.5 min. The use of the integrated autotransfusion system resulted in reduced postoperative transfusion requirements and helped maintain hemoglobin levels. Postoperative complications included gastrointestinal events (42.9%), wound infections (42.9%), and spinal cord deficit (14.3%). Early in-hospital mortality was 14.3% (one patient, postoperative day 5). Kaplan-Meier analysis showed a 1-week survival rate of 85.7%, with all surviving patients remaining alive throughout the follow-up period. Conclusion: The modified ECC system with integrated roller pumps and cell-saver technology demonstrated favorable short-term outcomes and effective blood conservation in open TAAA repair. This reservoirless, isothermic, centrifugal circuit with peripheral cannulation may offer a safe and efficient alternative for complex aortic surgery. Larger, prospective studies with extended follow-up are warranted to confirm these findings and evaluate long-term durability.