This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Edmunds, L H. Search for Related Content PubMed PubMed Citation Articles by Edmunds, L H., Jr Social Bookmarking                   What's this?

The evolution of cardiopulmonary bypass: lessons to be learned

Cecilie Greig Visiting Professor, Harrison Department of Surgical Research, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA, hedmunds{at}mail.med.upenn.edu

John Gibbon conceived cardiopulmonary bypass (CPB) and performed the first intracardiac repair using extracorporeal perfusion in 1953. This achievement stimulated rapid development of the knowledge base and equipment necessary for accurate diagnoses and successful intracardiac operations. In the early 60s increasing evidence indicated that exposure of blood to nonendothelial cell surfaces produced bleeding and thrombotic complications and a massive inflammatory response. Early efforts to discover a synthetic, nonthrombogenic surface gave way to efforts to control the ‘whole-body inflammatory response’ by pharmacological means. These efforts are ongoing; progress is slow; and heparin is still required for most applications of extracorporeal perfusion technology. Nevertheless, CPB now enables over one million cardiac surgical operations each year. Future progress and the development of artificial internal organs that process blood depend upon control of the blood -surface interface without anticoagulants.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				R. C. Becker Emerging constructs to maintain safety among patients with acute coronary syndromes requiring surgical coronary revascularization Eur. Heart J. Suppl., May 1, 2008; 10(suppl_D): D12 - D22. [Abstract] [Full Text] [PDF]

				C Marshall Utilising cardiopulmonary bypass for cancer surgery. Malignancy-induced protein C deficiency and thrombophilia. Perfusion, November 1, 2007; 22(6): 381 - 383. [Abstract] [PDF]

				O. Warren, C. Alexiou, R. Massey, D. Leff, S. Purkayastha, J. Kinross, A. Darzi, and T. Athanasiou The effects of various leukocyte filtration strategies in cardiac surgery Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 665 - 676. [Abstract] [Full Text] [PDF]

				C. Alexiou, A. T.M. Tang, S. V. Sheppard, M. P. Haw, R. Gibbs, and D. C. Smith A Prospective Randomized Study to Evaluate the Effect of Leukodepletion on the Rate of Alveolar Production of Exhaled Nitric Oxide During Cardiopulmonary Bypass Ann. Thorac. Surg., December 1, 2004; 78(6): 2139 - 2145. [Abstract] [Full Text] [PDF]

				M. Hravnak, L. A. Hoffman, M. I. Saul, T. G. Zullo, J. F. Cuneo, and R. V. Pellegrini Short-Term Complications and Resource Utilization in Matched Subjects After On-Pump or Off-Pump Primary Isolated Coronary Artery Bypass Am. J. Crit. Care., November 1, 2004; 13(6): 499 - 508. [Abstract] [Full Text] [PDF]

				A. M. Morariu, Y. J. Gu, R. C.G. G. Huet, W. A. Siemons, G. Rakhorst, and W. v. Oeveren Red blood cell aggregation during cardiopulmonary bypass: a pathogenic cofactor in endothelial cell activation? Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 939 - 946. [Abstract] [Full Text] [PDF]

				T. Gourlay, I. Samartzis, and K. M Taylor The effect of haemodilution on blood/biomaterial contact-mediated CD11b expression on neutrophils: ex vivo studies Perfusion, March 1, 2003; 18(2): 87 - 93. [Abstract] [PDF]