Utilization of a mass-infusion system in the management of ruptured abdominal aortic aneurysms: an alternative application for devices employed in cardiopulmonary bypass

To stabilize the hemodynamics before and during ruptured abdominal aortic aneurysmal repair, a mass-infusion system was developed and successfully employed in the treatment of two patients. The system consists of a combination of devices used in cardiopulmonary bypass, namely: suction, a reservoir, a heat exchanger, a bubble trap, and an intracaval large-sized venous femoral cannula for infusion. It proved extremely useful to tide the patients over hypovolemic shock before cross-clamping of the proximal aorta, preventing intraoperative hypothermia, which is known to cause multiple physiologic derangement associated with an adverse outcome. Moreover, the employment of a large-sized cannula allowed for a temporary switch from the preceding venous infusion support to the hypothermic circulatory assist with central aortic cannulation, using the caval cannula for drainage. This system provides an optional advantage for patients requiring an open proximal anastomosis.