Medtronic MYOtherm XP Instrucciones De Uso página 13

9. Attach the oxygenated blood line to the extracorporeal circuit and clamp securely before priming the
extracorporeal circuit.
10. Securely close both clamps, and insert the first IV spike of the cardioplegia line into the appropriate bag/
bottle containing the cardioplegia/priming solution. If only one spike is to be utilized, the second line clamp
should be moved down as close as possible to the "Y" connector and securely clamped. If both spiked lines
are to be used, the second line clamp should be moved up and securely clamped next to the spike to
facilitate the prime.
Warning: Use of a bottle for cardioplegia solution requires the presence of a functional standard air vent in
the bottle that extends at least 2.5 cm (1 in) above the top of the cardioplegia solution fluid level.
11. Attach the temperature probe to the temperature monitoring adaptor at the outlet port of the heat exchanger.
8.2. Priming
1. Prior to priming the cardioplegia system, the oxygenator and extracorporeal tubing circuit should be primed,
recirculated, and debubbled.
2. Priming of the cardioplegia system may be completed either before or immediately after the commencement
of cardiopulmonary bypass. If final priming of the cardioplegia circuit is to be deferred until after the
commencement of bypass, the system must be primed to a point beyond the roller pump. This avoids
inadvertent introduction of air into the oxygenator through the blood line from the cardioplegia system.
Note: When utilizing both spiked lines of the MYOtherm XP system with Cortiva bioactive surface: using the
primed line, retrograde prime the unprimed line until all air is removed, then clamp; insert the remaining
spike into the second cardioplegia solution bag/bottle; gently tap the spike and the tubing to remove any
bubbles; unclamp the second line only when ready to administer.
On bridge units only:
Ensure that all bridge clamps are opened momentarily to allow tubing bridge to be properly primed.
Note: Complete priming of this system with asanguineous pump prime will result in the delivery of
approximately 190 mL of asanguineous cardioplegia solution before the direct delivery of blood/cardioplegia
solution.
3. To prime the heat exchanger system:
a. Ensure that the stopcock on the pressure monitoring line is turned to the off position.
Note: The extracorporeal circuit must be actively recirculated during priming of the cardioplegia system.
b. Release the clamp from the blood line; rotate the pump slowly; release the clamp from the cardioplegia
line. Fill the system to a maximum flow of 100 mL/min.
Note: Ensure that all bubbles are removed from both lines proximal to the heat exchanger before
wetting the heat exchanger.
c. Ensure that the system pressure monitoring line and the pressure relief line are securely connected.
d. Stop the pump when the heat exchanger is appropriately filled. To facilitate complete debubbling of the
outlet filter media, it is recommended that the heat exchanger be removed from the holder, inverted, and
inspected for trapped air. Gently tap the heat exchanger to dislodge any remaining bubbles and pass
them to the outlet chamber for removal.
Do not use clamps or other tools to tap on the device to dislodge bubbles to avoid damaging the seals
and housing.
e. Turn the cardioplegia pump on at a low (<100 mL) flow, and momentarily clamp outlet line to activate
the pressure relief valve until all visible air is purged through the pressure relief line, and then stop the
pump. Open the stopcock to vent any remaining air in the heat exchanger.
f. Securely attach the pressure gauge to the transducer protector.
g. After priming the system and checking the system to ensure it contains no air bubbles, open the
pressure monitoring line to the manometer by turning the stopcock to the appropriate position. Ensure
that the monitoring line is filled with fluid to the stopcock. If this monitoring line is not used, turn the
stopcock on the pressure monitoring line to the off position.
4. Remove the tubing clamp from the system outflow line.
Caution: If the outlet line is not unclamped, pressure buildup >750 mmHg can occur causing the pressure
relief valve to activate.
5. Prime the extension/delivery line by slowly advancing the system pump head. Ensure that the delivery line is
connected securely to the outflow line of the MYOtherm XP system with Cortiva bioactive surface and that
this connection is bubble-free.
Warning:
a. This system must be free of air bubbles before administration of cardioplegia to the patient.
b. The heat exchanger must be in a 10° inclined position, as provided by the standard MYOtherm XP
holder position, at all times to help avoid introduction of air into the delivery line.
Instructions for Use English 11