Heparin-bonded circuits decrease myocardial ischemic damage: an experimental study.
BACKGROUND
Heparin-bonded cardiopulmonary bypass circuits reduce complement activation, but their effect on myocardial function is unknown. This study was undertaken to determine whether heparin-bonded circuits reduce myocardial damage during acute surgical revascularization.


METHODS
In 16 pigs, the second and third diagonal vessels were occluded with snares for 90 minutes followed by 45 minutes of cardioplegic arrest and 180 minutes of reperfusion with the snares released. During the period of coronary occlusion, all animals were placed on percutaneous bypass followed by standard cardiopulmonary bypass during the periods of cardioplegic arrest and reperfusion. In 8 pigs, heparin-bonded circuits were used, whereas 8 other pigs received nonbonded circuits.


RESULTS
Animals treated with heparin-bonded circuits had the best preservation of wall motion scores (3.5 +/- 0.3 versus 2.3 +/- 0.2; 4 = normal to -1 = dyskinesis; p < 0.05), least tissue acidosis (change in pH = -0.31 +/- 0.02 versus -0.64 +/- 0.08; p < 0.05), smallest increase in lung H2O (1.7% +/- 0.7% versus 6.1% +/- .5%; p < 0.05), and the lowest area of necrosis/area of risk (20.3% +/- 2.2% versus 40.4% +/- 1.6%; p < 0.05).


CONCLUSIONS
We conclude that heparin-bonded circuits significantly decrease myocardial ischemic damage during acute surgical revascularization.
Lazar
H L
HL
Department of Cardiothoracic Surgery, The Boston University Medical Center, Massachusetts 02118, USA.
Zhang
X
X
Hamasaki
T
T
Memmelo
C A
CA
Treanor
P
P
Rivers
S
S
Aldea
G S
GS
Bernard
S A
SA
Shemin
R J
RJ
D000136:Acid-Base Equilibrium / Q000502:physiology; D000818:Animals; D001672:Biocompatible Materials; D001834:Body Water / Q000502:physiology; D002315:Cardiopulmonary Bypass / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D006439:Hemodynamics / Q000502:physiology; D006493:Heparin / Q000008:administration & dosage*; D008168:Lung / Q000503:physiopathology; D009200:Myocardial Contraction / Q000502:physiology; D017202:Myocardial Ischemia / Q000517:prevention & control*; D011897:Random Allocation; D013552:Swine
D001672:Biocompatible Materials; D006493:Heparin