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


METHODS
Prospective, randomized, single-blind clinical trial.


METHODS
A primary care institution.


METHODS
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).


METHODS
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.


METHODS
Postoperative bleeding, transfusion requirements and clinical outcomes.


RESULTS
There were no complications related to the study protocol. Study groups were similar in terms of postoperative bleeding, transfusion requirements and clinical outcomes.


CONCLUSIONS
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.
Mullen
John C
JC
Division of Cardiac Surgery, The University of Alberta, Edmonton. jmullen@ualberta.ca
Bentley
Michael J
MJ
Gelfand
Elliot T
ET
Koshal
Arvind
A
Modry
Dennis L
DL
Guenther
Craig R
CR
Etches
Wai S
WS
Stang
Linda J
LJ
Lopushinsky
Steven R
SR
D000925:Anticoagulants / Q000008:administration & dosage*; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D003327:Coronary Disease / Q000097:blood / Q000601:surgery; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D016037:Single-Blind Method; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000925:Anticoagulants; D006454:Hemoglobins; D014409:Tumor Necrosis Factor-alpha; D006493:Heparin