Cardiopulmonary Bypass (CPB) and ECMO
Most children born with a congenital heart disease who need pediatric cardiac surgery will be placed on a heart-lung machine. This process is known as cardiopulmonary bypass (CPB). If your child requires cardiac surgery that involves CPB, our cardiothoracic surgery team will discuss this with you during your consultation.
What Is Cardiopulmonary Bypass?
CPB is a machine that is surgically connected to your child’s main blood vessels and does the work of the heart and lungs. By taking over these vital functions, the heart and lungs can remain still, allowing the surgeon to safely operate inside the heart with a clear, blood-free view. This provides a safe and controlled environment to perform even the most delicate and complex repairs.
Once the repair is complete, the heart and lungs are restarted, and your child is carefully weaned off the machine. This is a routine part of most pediatric heart surgery procedures.
Our Experience with CPB
The technology to safely perform CPB (and thus perform true open-heart surgery) has been around since the 1960s and has continuously improved in terms of safety and reliability. In the current era, we can put a patient of almost any size and age on CPB and expect a safe outcome.
Our Cardiovascular Surgery Program has had continuous experience using CPB in open-heart surgery for more than 30 years. The specialists who run the CPB machine are called perfusionists. Our vast experience—over thousands of cases and counting—means that your child’s perfusionist is a dedicated, expert professional. Our perfusionists have trained in the best centers and have considerable experience specifically with children. This is important, as not all centers are able to offer dedicated pediatric perfusionists. This assures you that this important member of the surgical team is among the best available.
Although CPB is safe for the vast majority of children, there remains an approximately 1 percent or less chance of having a complication related to CPB. If your child has special circumstances that make this baseline risk level higher, we will discuss this with you during your surgical consultation. Most CPB-related complications can be treated and do not result in major problems down the road.
ECMO (Extracorporeal Membrane Oxygenation)
For some babies who undergo heart surgery, a special CPB machine called ECMO (extracorporeal membrane oxygenation) may be required to support the baby in the first few days after surgery. In these cases, the machine does the same job—temporarily taking over for the heart and lungs. This allows babies to recover from an especially long or difficult procedure and protects their other organs (such as the kidneys and brain) while their heart and lungs recover.
At Rady Children’s Hospital–San Diego, our cardiac ECMO program has been in place since 1988. We have utilized ECMO more than 270 times in heart patients, saving many children who might not have otherwise had a chance. Only a few percent of children in our unit have required ECMO over the past five years. It can be difficult to predict who will need this special support. The risk is higher with ECMO than with CPB, but each child represents a unique circumstance. If your child requires this technology, our team will thoroughly discuss their condition and care plan with you.
Our cardiothoracic surgery team, cardiovascular perfusion experts, and the entire staff of Rady Children’s Cardiovascular Surgery Program are committed to providing compassionate, expert care for every patient and family.