Miniaturized biocompatible cardiopulmonary bypass for the Fontan procedure

Itatani, Keiichi; Miyaji, Kagami; Miyamoto, Takashi; Inoue, Nobuyuki; Tomoyasu, Takahiro; Kohira, Satoshi; Sato, Hajime; Ohara, Kuniyoshi
November 2010
Surgery Today;Nov2010, Vol. 40 Issue 11, p1040
Academic Journal
Purpose: Postoperative inflammatory response and perioperative systemic edema are the risks of failed Fontan circulation. We evaluated the efficiency of the miniaturized, poly-2-methoxyethylacrylate (PMEA)-coated cardiopulmonary bypass (CPB) circuit, which we devised in 2003, in the Fontan circulation. Methods: Thirty-seven patients who underwent the Fontan procedure between March 1996 and December 2006 were divided into two groups: one consisting of patients with a priming-volume >250 m on uncoated conventional bypass (group C; n = 20), and one consisting of those with miniaturized (<200 ml) and PMEA-coated circuits (group M; n = 17). We compared the body weight gain (%BWG), minimum platelet count, maximum postoperative C-reactive protein (CRP), and minimum hematocrit (Hct) levels during the operation, maximum white blood cell (WBC) count, and postoperative pleural effusion, between the two groups. Stepwise multiple logistic regression analyses were used to investigate the most affecting factors. Results: The %BWG and CRP levels were significantly lower in group M ( P = 0.047 and P = 0.012, respectively). The minimum platelet count was significantly higher in group M ( P = 0.012). There were no significant differences in postoperative pleural effusion, minimum Hct, or maximum WBC. Conclusion: The miniaturized biocompatible CPB system reduced perioperative inflammatory responses.


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