Coronary artery bypass surgery with heparin-coated perfusion circuits and low-dose heparinization

To evaluate the safety and efficacy of heparin-coated perfusion circuits with low-dose heparinization and centrifugal pumping compared with the standard method during coronary artery bypass grafting. Prospective, randomized, single-blind clinical trial. A primary care institution. Ninety patients wh...

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Bibliographic Details
Published in:Canadian Journal of Surgery 2002-06, Vol.45 (3), p.166-172
Main Authors: Mullen, John C, Bentley, Michael J, Gelfand, Elliot T, Koshal, Arvind, Modry, Dennis L, Guenther, Craig R, Etches, Wai S, Stang, Linda J, Lopushinsky, Steven R
Format: Article
Language:English
Subjects:
Anticoagulants - administration & dosage
Blood Transfusion
Cardiopulmonary Bypass - instrumentation
Coronary Artery Bypass - instrumentation
Coronary Disease - blood
Coronary Disease - surgery
Female
Hemoglobins - analysis
Heparin - administration & dosage
Humans
Male
Middle Aged
Original
Postoperative Hemorrhage - prevention & control
Prospective Studies
Single-Blind Method
Tumor Necrosis Factor-alpha - analysis
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Summary:To evaluate the safety and efficacy of heparin-coated perfusion circuits with low-dose heparinization and centrifugal pumping compared with the standard method during coronary artery bypass grafting. Prospective, randomized, single-blind clinical trial. A primary care institution. Ninety patients who underwent first-time elective coronary artery bypass grafting were eligible for the study. After giving informed consent, they were randomly assigned to 1 of 3 groups (30/group). Perfusion on regular uncoated bypass equipment with a roller pump and full-dose heparinization (300 IU/kg bolus, activated clotting time [ACT] > 400 s) (group 1), on a heparin-coated oxygenator with a centrifugal pump and full-dose heparinization (group 2) and on fully heparin-coated bypass equipment with a centrifugal pump and low-dose heparinization (100 IU/kg bolus, ACT of 180-400 s) (group 3). Standard coronary artery bypass grafting was performed. Postoperative bleeding, transfusion requirements and clinical outcomes. There were no complications related to the study protocol. Study groups were similar in terms of postoperative bleeding, transfusion requirements and clinical outcomes. Heparin-coated cardiopulmonary bypass with low-dose heparinization and centrifugal pumping is a safe practice but showed no advantages over the use of regular uncoated bypass circuits for coronary bypass surgery.
ISSN:0008-428X
1488-2310