Early experience with the minimal extracorporeal circulation system (MECC®) during thoracoabdominal aortic aneurysm repair

Aim. The purpose of this report is to describe our early experience with a minimal extracorporeal circulation system (MECC), a compact closed heparin coated system consisting of a centrifugal pump and a membrane oxygenator, during thoracoabdominal aortic aneurysm (TAAA) repair. Methods. Between January and December 2002 the MECC system was employed in seven consecutive patients (four TAAA type II, two TAAA type I and one TAAA type III according to the Crawford classification). In all patients distal aortic, selective renal and visceral perfusion was performed with this compact closed heparin coated system consisting of a centrifugal pump and a membrane oxygenator. Results. The MECC system was used in all cases with no technical malfunctions. Six out seven patients were discharged from the unit. One patient developed paraplegia after TAAA repair and died on the third post-operative day from multiorgan failure. In this case the total spinal ischaemic time was 120 min and the distal aortic perfusion pressure was <50 mmHg. No cardiac, cerebral, renal, hepatic or bleeding complications were recorded in the remaining six patients. Conclusion. Our early experience with MECC during TAAA repair showed that it is feasible for distal aortic spinal and visceral selective perfusion. Further large clinical trials are required to determine the efficacy of this technique.