The very first cardiopulmonary bypass surgery in Canada, using the Sorin Biomedica Synergy Miniature Bypass System, was performed at Trillium Health Centre in March 2004.
“This device looks like a large blender as opposed to a small Volkswagen,” explains Dr. Gopal Bhatnagar, chief of cardiac surgery at Trillium. “We’re hoping this will certainly make a big difference in the amount of blood transfusions we require. The better patients do, the less resources are utilized to take care of them, which means perhaps less financial impact in the long run to health care institutions.”
“As far as patient outcomes go,” says Dr. Charles Cutrara, cardiac surgeon at Trillium, “we’re looking at a number of different criteria. We’re trying to get the patients out of the hospital faster and back to their lives; trying to get them back to work faster with fewer complications; overall, we’re trying to decrease their exposure to blood products and infections and still provide the same quality cardiac surgical procedure they would have had otherwise.”
Since its invention and first clinical use in 1953, the heart lung machine has enabled cardiac surgery to proceed at an enormous rate. By taking over the function of the heart and lungs for a patient undergoing cardiac surgery, the new bypass system can offer an alternative for patients who must go on bypass and are not candidates for off-pump surgery, while decreasing the risk of neurological and renal complications, blood utilization, and length of stay. “This new pump is basically a quantum leap in technology beyond the old heart lung machine,” says Dr. Cutrara. “All of the components have been miniaturized and incorporated into something that’s much more compact.”
By focusing not only on the disposable part of the circuit, the pump oxygenator, but also on the total footprint of the system, Sorin succeeded in miniaturizing the system. Currently, the Miniature Bypass System is in use in 13 centres across Europe, and the results prove this is the direction in which Cardiac Surgery should be headed. The Miniature Bypass System dramatically decreases the invasiveness of the procedure, in terms of how the patient behaves post operatively, how fast they recover, and their level of agitation.
As Trillium’s chief cardiovascular perfusionist Cyril Serrick explains, “with the decreased dilutional effect that cardiopulmonary bypass has on our patients, the biggest advantage we will see is a drastic decrease in blood transfusions. Because patients are not hemodiluted as much patients require fewer transfusions and they don’t bleed as much with such a system.”
“This type of technology hasn’t been available before because there was no perceived need,” says Dr. Cutrara. “People were very comfortable with the old cardiopulmonary bypass set up and it wasn’t until the introduction of beating heart surgery that perfusion technology began making improvements.” “It’s a little bit of healthy competition in that sense,” explains Dr. Bhatnagar, “If there was no competition, we’d still be driving the Ford Model T today. Competition, I think, breeds new technology and innovation in an attempt to improve patient outcomes.”
In the past, many patients who desperately needed heart surgery were unable to have the procedure because they were too sick to tolerate it. As a leader in Cardiac Care, performing more than 7,000 heart-related procedures per year, Trillium is working to ensure that anyone who will benefit from the procedure can receive a safe and timely heart operation. Innovative new practices and techniques are bringing Trillium one-step closer to their goal.
The new Miniature Bypass System supports Trillium’s vision to be leaders in their field, and aligns with Trillium’s strategic priority to develop world-class programs and services by providing optimal patient care through innovative technology, techniques and thinking. “I think this speaks to the kind of team that’s here and the support that we’ve received from the hospital,” says Dr. Bhatnagar. “These kinds of initiatives are only possible if you’ve got a team that’s open minded about advances and an administration that’s willing and able to look at new initiatives. I think it’s important that we acknowledge that a well-run hospital allows clinicians to be able to take advantage of these opportunities when they arise.”
Trillium is only the first hospital in Canada and the second facility in North America to use this new technology.