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Chapter 13 Weaning and Explantation for BTR and BTT
In the operating room, explantation should be considered if the following criteria are
met with the pump stopped for 20 minutes (after anticoagulation has been established
in the target range for cardiopulmonary bypass):
• LVEDD less than 98th percentile (Z-score less than +2)
•
EF ≥ 45 % (i.e. no more than mild ventricular dysfunction)
• Normotensive on only Milrinone (no other inotropes)
• Lactate <3 mmol/L
•
LVEDP < 12 mmHg
• Resting CI of > 2.8 L/min/m
2
Surgery should be performed without Cardiopulmonary Bypass. Control all bleeding
immediately during and post implantation.
13.2 Explantation for BTR
13.2.1 Explantation with univentricular support
The procedure is analogous to that used after BTT (see section 13.3: Explantation for
BTT, page 168). Sew over all anastomosis areas where cannulae were placed.
13.2.2 Explantation after biventricular support
Stopping the right pump
INSTRUCTION
1. Select Pause right (see Fig. 13-1, page 167), then press <Enter> to confirm.
Respond to the prompt in the dialog window by pressing the <X> key or the
<1> key. The right pump will stop. The view Pump size and single-step mode
is shown (see Fig. 7-7, page 100). The cursor is located on the OK field.
2. Unplug the driving tube of the right pump from the connector on the Ikus. Use
the seal plug to seal the connector.
3. To confirm the OK selection, press <Enter> . The Ikus continues running. The
screen shows the standard view.
Fig. 13-1 Pause right
Switching the Ikus off
WARNING
The Ikus power switch (toggle switch) should always be in the [I]
position, even if the main switch (key switch) is in the [0] position!.
Otherwise there is a risk that the drive may fail in future due to the Ikus
batteries being totally discharged.
Always follow the above sequence of operations. Always use the key
switch to switch off the Ikus.
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