Mini extracorporeal circuit for coronary artery bypass grafting: initial clinical and biochemical results

van Boven, W.J.; Gerritsen, W.B.; Waanders, F.G.; Haas, F.J.; Aarts, L.P.
July 2004
Perfusion;Jul2004, Vol. 19 Issue 4, p239
Academic Journal
Background: The new concept of mini-extracorporeal circulation (MECC) for coronary artery bypass grafts (MCABG) consists of minimal priming volume, a heparin-coated closed circuit, a centrifugal pump, active drainage, blood cardioplegia and a cell-saving device. The potential organ protective effect of this technique during CABG is unknown. Initial clinical outcomes, oxidative stress, alveolar shunting and need for blood transfusion were investigated for MCABG patients. Subsets of these data were compared to outcomes of matched groups of patients operated conventionally (CCABG) and off-pump (OPCAB). Methods: Data of 184 patients were gathered and analysed from a prospective observational database system. This database consists of the initial experience with the first 114 MCABG operations. Of these, the clinical outcome was investigated. In a subset of 60 MCABGs, need for transfusion was monitored and compared to 60 CCABGs. Serum concentrations of malondialdehyde (MDA), allantoin/urate ratios, shunt fractions and lung epithelium-specific proteins (CC16) were measured as biomarkers of damage during MCABG, CCABG and OPCAB (n = 30). Results: Patient groups were similar concerning age, risk and number of distal anastomoses. Clinical outcomes are shown for MCABGs only. During MCABG, need for transfusion was significantly reduced compared to CCABG (p < 0.001). Serum concentrations of MDA and allantoin/urate ratios showed significantly reduced oxidative stress during MCABG compared to CCABG. During MCABG, F-shunts were reduced shortly after surgery. Increased concentrations of pneumoprotein CC16 were measured during CCABG compared to MCABG (data submitted). Conclusion: Short-term clinical outcomes of MCABG patients are satisfactory. Compared to CCABG the need for transfusion is significantly reduced when a MECC is used. Oxidative stress parameters show a tendency towards improved global organ protection compared to CCABG. F-shunt fractions and CC16 concentrations suggest reduced alveolar damage during MCABG. In a prospective study, the protective effect of mini-CABG has to be confirmed.


Related Articles

  • Coronary artery bypass grafting surgery is associated with a marked reduction in serum homocysteine and folate levels in the early postoperative period Storti, Simona; Cerillo, Alfredo Giuseppe; Rizza, Antonio; Giannelli, Isabella; Fontani, Giuliana; Glauber, Mattia; Clerico, Aldo // European Journal of Cardio-Thoracic Surgery;Oct2004, Vol. 26 Issue 4, p682 

    Objective: It has been suggested that cardiac surgery-related ischemia-reperfusion injury to the myocardium is caused by the oxidative stress, derived from the formation of reactive oxygen species in the early phases of the reperfusion. The availability of cysteine, mostly deriving from...

  • Variation in Use of Blood Transfusion in Coronary Artery Bypass Graft Surgery. Bennett-Guerrero, Elliott; Yue Zhao; O'Brien, Sean M.; Ferguson Jr., T. B.; Peterson, Eric D.; Gammie, James S.; Song, Howard K. // JAMA: Journal of the American Medical Association;10/13/2010, Vol. 304 Issue 14, p1568 

    The article focuses on an observational cohort study which assessed hospital-level variation use of allogeneic red blood cells (RBC) fresh-frozen plasma, and platelet transfusions in patients undergoing coronary artery bypass graft (CABG) surgery. The study examined patients undergoing primary...

  • CABG study links transfusions with infection.  // Medical Device Daily;8/4/2009, Vol. 13 Issue 148, Special section p1 

    The article deals with a study published in "BMC Medicine" which examined hospital variation in blood use and outcomes in cardiac surgery patients. Several coronary artery bypass graft (CABG) patients served as subjects in this study. Results of the study showed that 30% of the variation in...

  • Blood component utilization in cardiac revascularization in comparison of on-and off pump techniques in a tertiary care hospital of North India. Sonker, A.; Chaudhary, R.; Agarwal, S.; Pandey, S.; Khetan, D. // Asian Journal of Transfusion Science;Jul-Dec2007, Vol. 1 Issue 2, p97 

    Introduction: Cardiac revascularizations on a beating heart avoid the side effects of cardiopulmonary bypass (neurological injury and hemodilution and coagulopathy). We examined peri-operative use of blood components during coronary artery bypass grafting using either on-pump or off-pump...

  • Influence of pericardial suction blood retransfusion on memory function and release of protein S100B. Svenmarker, S.; Engström, K.G.; Karlsson, T.; Jansson, E.; Lindholm, R.; Åberg, T. // Perfusion;Nov2004, Vol. 19 Issue 6, p337 

    Background: To study the influence of pericardial suction blood (PSB) on postoperative memory disturbances and release patterns of protein S100B during and after cardiopulmonary bypass (CPB). Methods: Sixty male patients admitted for coronary artery bypass surgery were prospectively randomized...

  • Complete arterial coronary revascularisation using radial artery conduit for double thoracic artery inlet flow: arterial sling operation Christensen, John B.; Lund, Jens T.; Kassis, Eli; Kelbæk, Henning // European Journal of Cardio-Thoracic Surgery;Mar2002, Vol. 21 Issue 3, p391 

    Background: Coronary artery bypass graft surgery with arterial revascularisation of all diseased coronary vessels is considered highly efficient because arterial grafts have an excellent long-term patency compared with venous grafts. However, problems to reach the infero-lateral wall with the in...

  • Off-Pump Coronary Artery Bypass Grafting and Transmyocardial Laser Revascularization. Gregoric, Igor; Messner, Gregory; Couto, Wilson J.; Sartori, Michele; Cervera, Roberto; Kadipasaoglu, Kamuran; Frazier, O.H. // Texas Heart Institute Journal;2003, Vol. 30 Issue 1, p13 

    Off-pump coronary artery bypass grafting may be combined with adjunctive transmyocardial laser revascularization to optimize revascularization. This approach may be advantageous for high-risk patients, particularly those having undergone previous sternotomies. From October 2000 through May 2001,...

  • Fewer off-pump CABG procedures performed in past decade.  // Cardiology Today;Jun2014, Vol. 17 Issue 6, p24 

    The article reports on the decline in the use of off-pump coronary artery bypass surgery (CABG).

  • CTO PCI outcomes improving for patients with prior CABG.  // Cardiology Today;Jun2014, Vol. 17 Issue 6, p48 

    The article reports on the positive outcomes of chronic total occlusion and percutaneous coronary intervention (CTO PCI) for patients with previous coronary artery bypass grafting (CABG).


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics