title: No clear clinical benefit of using mini-invasive extracorporeal circulation in coronary artery bypass grafting in low-risk patients.
abstract: BACKGROUND
  Current research is engaged in innovative technologies of extracorporeal circulation (ECC) systems in an effort to eliminate negative effects. Some studies have shown that, due to the complexity of technical settings of mini-ECC, they invoke a weaker immune response compared to classic ECC. The clinical benefits of using these systems have not been clearly proven yet.
  
  
  METHODS
  A group of 54 patients who were indicated for elective coronary surgery were randomised into two groups - Group A (patients operated on using classic ECC - open modification) and Group B (patients operated on using mini-ECC). The concentrations of IL-6, PMN elastase and MCP-1 in both groups were monitored per- and postoperatively, along with the postoperative clinical course.
  
  
  RESULTS
  The groups did not differ in the basic pre- and peroperative characteristics. We recorded a lower priming for mini-ECC (p < 0.001) and significantly reduced hemodilution during ECC. There were no differences in the clinical outcome in either group. Serum concentrations of monitored markers of immune reaction towards ECC showed higher activity during standard ECC.
  
  
  CONCLUSIONS
  New technologies used in mini-systems have proven to lower activation of the immune system, which can be monitored using kinetics of proinflammatory mediators. In spite of these comparable laboratory results, we did not find differences in short-term clinical results when comparing both these groups of low-risk patients.
authors.affiliation: Department of Cardiac Surgery of Charles University in Prague, Faculty of Medicine in Hradec Kralove and University Hospital in Hradec Kralove, Czech Republic. vladimirsvitek@centrum.cz
authors.forename: Vladimir
authors.initials: V
authors.lastname: Svitek
authors.forename: Vladimir
authors.initials: V
authors.lastname: Lonsky
authors.forename: Jiri
authors.initials: J
authors.lastname: Mandak
authors.forename: Jan
authors.initials: J
authors.lastname: Krejsek
authors.forename: Martina
authors.initials: M
authors.lastname: Kolackova
authors.forename: Vladimir
authors.initials: V
authors.lastname: Brzek
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Kubicek
authors.forename: Martin
authors.initials: M
authors.lastname: Volt
authors.forename: Michael
authors.initials: M
authors.lastname: Bartos
authors.forename: Jan
authors.initials: J
authors.lastname: Harrer
mesh_terms: D000368:Aged; D018932:Chemokine CCL2 / Q000097:blood; D001026:Coronary Artery Bypass / Q000379:methods*; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D018932:Chemokine CCL2; D015850:Interleukin-6; D019272:Leukocyte Elastase