Simplified total body perfusion. Reduced flows, moderate hypothermia, and hemodilution.

IN THE PAST 6½ years nearly 1,500 total body perfusions have been performed at this center and many thousands elsewhere. "Things are never so good that they might not be better" and this philosophy has stimulated us to reexamine our techniques for total body perfusion for open cardiotomy in light of our own experience and that of others. Promoters of the maximum flow techniques have not provided any convincing evidence that their more complicated methods have superiority, nor have the "deep coolers" in their efforts to achieve technical simplicity provided results, at least to date, that are likely to warm the hearts of their confreres. From the time open heart surgical procedures began there has been a trend towards increasingly complex pump-oxygenators, heating exchange units, numbers of personnel required, more complicated ancillary monitoring devices, and greater blood priming requirements, without any corresponding decrease in patient morbidity and mortality. It has