Cardiopulmonary bypass

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Diagram of a heart-lung machine used in cardiopulmonary bypass
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Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump is often referred to as a "heart-lung machine" or "the pump".

History[edit | edit source]

The development of cardiopulmonary bypass was a significant milestone in cardiac surgery. The first successful use of a heart-lung machine was in 1953 by Dr. John Gibbon, who used it to perform an open-heart surgery. The machine has since evolved significantly, with improvements in safety and efficiency.

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Early heart-lung machine from 1955

Components[edit | edit source]

The main components of a cardiopulmonary bypass machine include:

  • Oxygenator: This component adds oxygen to the blood and removes carbon dioxide, mimicking the gas exchange function of the lungs.
  • Pump: The pump circulates the blood through the body, replacing the pumping action of the heart.
  • Heat exchanger: This allows the surgical team to control the temperature of the blood, which can be important for certain procedures.
  • Filters: These remove air bubbles and other debris from the blood to prevent embolism.

Procedure[edit | edit source]

During cardiopulmonary bypass, the patient's blood is diverted from the heart and lungs to the heart-lung machine. The machine oxygenates the blood and returns it to the body, allowing the surgeon to operate on a still and bloodless heart.

A perfusionist operating a heart-lung machine

Applications[edit | edit source]

Cardiopulmonary bypass is primarily used in open-heart surgery, such as coronary artery bypass grafting (CABG), heart valve repair or replacement, and heart transplant surgeries.

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Coronary artery bypass surgery

Risks and Complications[edit | edit source]

While CPB is generally safe, it can be associated with complications such as:

  • Bleeding: Due to anticoagulation required during the procedure.
  • Stroke: From air embolism or debris.
  • Inflammatory response: Triggered by the contact of blood with the artificial surfaces of the machine.

Also see[edit | edit source]



Cardiovascular disease A-Z

Most common cardiac diseases

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Contributors: Kondreddy Naveen, Prab R. Tumpati, MD