The use of a mini bypass system (Cobe Synergy) without venous and cardiotomy reservoir in a mitral valve repair: a case report.

The use of mini cardiopulmonary bypass circuits is an emerging technology. The venous and cardiotomy reservoir have been excluded from the circuit. This results in a reduction of the blood contact surface area and of the priming volume. Entrainment of venous air, however, remains a drawback in the widespread acceptance of using these mini circuits. The technique described resolves this problem by automatic removal of venous air, and explains how this mini cardiopulmonary bypass circuit was utilized on a 64-year-old female presented for a mitral valve repair. In the absence of a cardiotomy reservoir, an autotransfusion cell separator was used to process shed blood and, after CPB, the residual pump blood. This mini bypass circuit, with the safety feature to remove automatically venous air, provided an additional degree of protection. In our experience, mini bypass circuits allow us safely to perform cardiopulmonary bypass during valve procedures.