Cardiopulmonary bypass in infants and children: what’s new?

Abstract

In the early 1950s the pioneers of congenital cardiac surgery, among them Bigelow, Lewis and Gibbon, realised that hypothermia and inflow occlusion alone would not allow further advances in the field. In 1954, Lillehei introduced the technique of controlled cross circulation, where the patient’s parent functioned as the extracorporal oxygenator. Only the development of mechanical cardiopulmonary bypass circuits in the late 1950s made advanced congenital cardiac surgery possible. Since then, extracorporal perfusion circuits have come a long way: from monkey lungs, film and bubble oxygenators, to modern miniature membrane oxygenators with centrifugal pumps, vacuum-assisted venous drainage and in-line gas monitoring.1