The efficacy of low prime volume completely closed cardiopulmonary bypass in coronary artery revascularization.
OBJECTIVE
This study was conducted to evaluate and demonstrate the efficacy of low prime volume completely closed cardiopulmonary bypass (LPVP) in arrested coronary artery bypass grafting (CABG). We improved the percutaneous cardiopulmonary support (PCPS) circuit to reduce the deleterious effects of cardiopulmonary bypass (CPB).


METHODS
Between April 1999 and May 2003, among 228 isolated CABG procedures, 47 procedures using LPVP (group L) and 86 procedures using standard prime volume open CPB (group S) were compared. The LPVP priming volume was 590 mL; the circuit was completely closed with a soft reservoir. Cardiac arrest was obtained by warm blood cardioplegia.


RESULTS
The following average values were obtained: packed red blood cell transfusions, 0.88 +/- 1.4 U (group L) vs. 2.1 +/- 2.5 U (group S); intraoperative lowest hematocrit value, 28.7 +/- 4.6% (group L) vs. 22.4 +/- 3.3% (group S); blood loss over first 24 hours, 439 +/- 242 mL (group L) vs. 599 +/- 409 mL (group S); ventilation time, 5.1 +/- 3.1 hours (group L) vs. 10.4 +/- 14.9 hours (group S).


CONCLUSIONS
Compared to standard prime volume open CPB, LPVP resulted in fewer deleterious operative effects. Less blood loss, fewer blood transfusions, and earlier patient recovery was noted with LPVP. Thus, LPVP is a very efficient form of CPB.
Takai
Hideaki
H
Department of Cardiovascular Surgery, Nagasaki University School of Medicine, Nagasaki, Japan.
Eishi
Kiyoyuki
K
Yamachika
Shiro
S
Hazama
Shiro
S
Nishi
Katsuo
K
Ariyoshi
Tsuneo
T
Nakaji
Shun
S
Matsumaru
Ichiro
I
D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric