Minimal extracorporeal circulation is a promising technique for coronary artery bypass grafting.
BACKGROUND
Minimal extracorporeal circulation (MECC) is a promising perfusion technology, taking the advantage of an ECC while having a significantly reduced priming volume. We analyzed the actual possible benefits of using MECC in patients undergoing CABG procedures and compared the results with conventional extracorporeal circulation (CECC).


METHODS
One thousand fifty-three consecutive patients underwent CABG surgery using the MECC perfusion technique. Subgroup analyses focused on perioperative myocardial markers (cardiac troponin I [cTnI]), incidence of atrial fibrillation (AF), and perioperative evaluation of inflammatory markers and data were compared with those of patients who underwent CABG using CECC. A propensity score analysis was performed.


RESULTS
Patient characteristics and distribution of EuroSCORE risk were similar in both groups. Severity of coronary artery disease and extent of revascularization were also comparable in both groups (number of distal anastomoses: 3.2 +/- 1.1 in CECC vs 3.2 +/- 0.9 in MECC; p = not significant [ns]). The cTnI was significantly lower in the MECC group (11.0 +/- 10.8 microg/L in MECC vs 24.7 +/- 25.3 microg/L in CECC; p < 0.05). Incidence of AF was 11.1% in MECC and 39.0% in CECC (p < 0.05). Inflammatory markers (interleukin-6, SC5b-9) were lower in MECC patients (p < 0.05). Propensity score analysis confirmed faster recovery in MECC patients and lower incidence of AF.


CONCLUSIONS
Minimal extracorporeal circulation is a safe perfusion technique for CABG and may therefore concurrence OPCAB and traditional CABG under CECC.
Immer
Franz F
FF
Department of Cardiovascular Surgery, University Hospital, Berne, Switzerland. franzimmer@yahoo.de
Ackermann
Andreas
A
Gygax
Erich
E
Stalder
Mario
M
Englberger
Lars
L
Eckstein
Friedrich S
FS
Tevaearai
Hendrik T
HT
Schmidli
Juerg
J
Carrel
Thierry P
TP
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology; D002315:Cardiopulmonary Bypass; D015938:Complement Membrane Attack Complex; D003165:Complement System Proteins / Q000032:analysis; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D005112:Extracorporeal Circulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies
D015938:Complement Membrane Attack Complex; D015850:Interleukin-6; C047610:SC5b-9 protein complex; D003165:Complement System Proteins