Platelet function after off pump coronary surgery.
BACKGROUND
Little is known about the impact of off pump coronary artery bypass (OPCAB) on platelet function. Although improved platelet function may decrease bleeding and reduce cerebral and pulmonary damage, there is a concern that changes in platelet function may also accentuate bypass graft occlusion or other thrombotic processes. In this pilot study we used a point-of-care test--Hemostatus (Medtronic, Minneapolis, MN, USA)--to assess changes in platelet function after OPCAB.


METHODS
We analyzed data from 11 adult patients undergoing CAB surgery whose platelet function was assessed before and after OPCAB. A Hemostatus test was conducted prior to heparin administration and after protamine reversal.


RESULTS
There was a significant improvement in platelet function as measured in both channels 5 and 6 of the Hemostatus test. Blood loss was 598 +/- 244 mL in the first 24 hours. One patient received blood products.


CONCLUSIONS
This pilot study suggests that platelet function is not diminished but instead is improved after OPCAB. This improvement may be due to the release of newer, larger platelets from the bone marrow into the circulation. This finding has important implications for the use of antiplatelet agents perioperatively. Furthermore, more detailed studies in this field are needed.
Bidstrup
Benjamin P
BP
James Cook University, Townsville, The Townsville Hospital, Douglas, Queensland, Australia. benjamin.bidstrup@bigpond.com
Scarrott
Helen
H
Luque
Monica
M
D000925:Anticoagulants / Q000008:administration & dosage; D001792:Blood Platelets / Q000502:physiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D005434:Flow Cytometry; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015539:Platelet Activation; D010974:Platelet Aggregation; D010979:Platelet Function Tests / Q000295:instrumentation / Q000379:methods
D000925:Anticoagulants; D006493:Heparin