Medizintechnik Guinness World record for the smallest heart-lung machine

The small miracle machine allows heart surgery in infants without blood

The cardiologist Wolfgang Böttcher of the German Heart Center Berlin (DHZB) has received the official world record certificate of the "Guinness World of Records" company for the heart-lung-machine with the world's smallest filling volume. Although perhaps some people can not do anything with this record, decades of development work are behind the project. Because the little helper allows complicated heart surgery on newborns without canned blood, which has significant advantages for the baby.

The German Heart Center Berlin reports that complex congenital heart defects often have to be operated very soon after birth. The heart is connected to a heart-lung machine for this operation. This must first be filled with a suitable liquid, so that no air is pumped into the body. In the past, donor blood was often used as the fluid, which, despite the most careful examination, harbored a certain risk potential for infections and intolerance reactions. Today, the heart-lung machine is usually filled with a sterile electrolyte solution.

The heart-lung machine with the world's smallest filling volume allows heart surgery in newborns without the use of foreign blood. (Image: Africa Studio / fotolia.com)

What is the big advantage of the small filling volume?

The electrolyte solution causes a temporary dilution of the blood. In adult patients, however, this poses no danger. For newborns or toddlers, however, such a dilution can have far more drastic consequences, since just circa 85 milliliters of blood per kilogram of body weight circulate in the newborn. Therefore, so far had to be used in such operations alien blood canned food. However, the filling volume of the new heart-lung machine of the German Heart Center Berlin is so small that even babies can be operated on with an electrolytic solution without the blood thinning too much. This allows foreign blood-free interventions.

The development of the little miracle machine

One developmental problem was that the machine's main components, the pump and the oxygenator, could not be downsized further. "The largest portion of the filling volume of a heart-lung machine, however, does not require its individual components, but the tubes that connect the components to one another and lead from the heart-lung machine to the patient," explains DHZB cardiologist Wolfgang Böttcher. Thus, the developers concentrated on keeping the hose connections as short as possible. So the solution was to put the machine components as close as possible to each other and place the machine as close to the operating table as possible without the operator having to restrict his work. "This may seem relatively simple at first, but it is a challenge in the details," reports Böttcher in a report by the DHZB. From the reliable function of the heart-lung machine finally hang the life of a child. Any change to this system must be meticulously planned and implemented.

The years of work pay off

With a filling volume of 73 milliliters, the heart-lung machine achieved the world record. In the meantime, the DHZB is the only heart center in the world where neonatal and preterm newborn babies can be operated without blood products, even in preterm infants less than 2000 grams of birth weight. "Not only can we minimize the risks of infection and intolerance, but we also often enable our patients to recover faster after the operation," says Prof. Joachim Photiadis, head of the Department of Pediatric Cardiac Surgery at the DHZB. According to Photiadis, it has been proven that the respiratory time required after the operation and thus, in most cases, the stay of the patient in the intensive care unit is shorter on average if one does not use foreign blood. In addition, a heart-lung machine that does not need to be filled with donor blood can be used more quickly and is available faster for the next patient. (Fp)