Setup – Bypass Wean & Closure

Blows on the lungs.

Flow down, head down, Xclamp off, flow back up.

Cross-clamp off and partially clamped just distal to the root vent to allow any air to be collected in a pocket there and sucked out.

Apply pacing wires. Pace.

To Anaesthetist/Perfusionist: Ventilating, Gases ok, Warm.

Self: ECG (Rate, Rhythm, ST), Surgical site bleeding, CO2 tracing for ventilation, Level the table.

Weaning off bypass. Fill the heart – watch the arterial tracing to see the heart eject. Enough filling. Start reducing. Three-quarters. Half-flow. Quarter-flow. Off there. Venous line clamped. (Remove venous line.)

Check if anaesthetist happy.

Vent off. Protamine. (Remove the vent. Oversew.)

(Tie off venous line. Oversew.)

Take back venous volume. Trickle the remaining volume in.

Pack the pericardium. Haemostasis. Drains.

Remove swabs.

Close chest.

 

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