The temporary substitution of a pump oxygenator for the heart and lungs allows the surgeon to stop the heart and perform cardiac procedures under direct vision in a relatively dry,motionless field.It also allows the surgeon to manipulate the heart without the risk of producing ventricular fibrillation and reduced cardiac output that jeopardize perfusion to the myocardial,peripheral,and cerebral tissues.In traditional cardiopulmonary bypass (CPB),systemic venous return to the heart flows by gravity drainage through cannulae placed in the superior and inferior venae cavae or through a single two-stage cannula in the right atrium into tubing connected to the bypass machine.Blood is oxygenated,filtered,warmed or cooled,and pumped back into the systemic circulation through a cannula placed in the:

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In traditional cardiopulmonary bypass (CPB)circuits,systemic venous return to the heart flows by gravity drainage through cannulae placed in the superior and inferior venae cavae or through a single two-stage cannula in the right atrium into tubing connected to the bypass machine.Blood is oxygenated,filtered,warmed or cooled,and pumped back into the systemic circulation through a cannula placed in the ascending aorta or occasionally in the femoral artery (Figure 24-39)or the axillary artery.

The Temporary Substitution of a Pump Oxygenator for the Heart