Clinical study of biocompatibility between open and closed heparin-coated cardiopulmonary bypass circuits.
The objective of this study was to investigate the difference between the closed circuit system and the open circuit system in clinical heparin-coated cardiopulmonary bypass (CPB) circuits with a centrifugal pump. We evaluated the coagulation, fibrinolysis, and inflammatory response in valvular heart surgery. Nineteen patients were assigned at random to a group for the closed circuit system or the open circuit system. This is the first report on the effect of a closed circuit in valvular surgery. We measured the platelet count, white blood cell count, plasma fibrinogen concentration, thrombin-antithrombin III complex, plasmin-Alpha2 plasmin inhibitor complex, D-dimer, interleukin-6, polymorphic neutrophil-elastase, and the plasma free hemoglobin. Blood samples were collected before the start of perfusion, 15 and 60 min after the start of perfusion, 60 min after the administration of protamine, and 1 day after the operation. During the perfusion, coagulation, fibrinolysis, and inflammatory responses were activated; however, no significant differences between the two groups were noted. In this clinical investigation with suction and the cell saving system, the closed circuit was not found to be superior to the open circuit with regard to biocompatibility.
Tanaka
Hiroyuki
H
Department of Thoracic Cardiovascular Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, 227-8501, Yokohama, Japan. h.tanaka@showa-university-fujigaoka.gr.jp
Oshiyama
Takanori
T
Narisawa
Takashi
T
Mori
Takanobu
T
Masuda
Mikio
M
Kishi
Daijirou
D
Kitou
Takashi
T
Miyazima
Shingo
S
D000368:Aged; D001774:Blood Chemical Analysis; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D020099:Coated Materials, Biocompatible; D004867:Equipment Design; D004869:Equipment Safety; D005112:Extracorporeal Circulation / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D006493:Heparin