title: Evaluation of closed cardiopulmonary bypass circuit for aortic valve replacement.
abstract: Since 2005, we have used a novel technique based on the closed cardiopulmonary bypass system without cardiotomy suction (minimal cardiopulmonary bypass [mini-CPB]) for aortic valve replacement (AVR). In this study, we investigated the clinical advantages of this approach. We prospectively studied 32 patients who underwent isolated AVR using the mini-CPB (group M, n = 13) or conventional CPB (group C, n = 19). We compared the hemodilution ratio, serum interleukin (IL)-6 and IL-8 levels, and blood transfusion volume between the two groups. The characteristics, duration of CPB, and aortic cross-clamping time did not differ between the two groups. The hemodilution ratio was significantly lower in group M just after starting CPB (M vs. C: 14% +/- 2% vs. 25% +/- 3%, p = 0.0009). IL-6 levels increased significantly after surgery in both groups, but the postoperative levels were significantly lower in group M at 6 (84.9 +/- 24.9 pg/ml vs. 152 +/- 78 pg/ml, p = 0.042) and 12 (72.7 +/- 36.1 pg/ml vs. 123 +/- 49.6 pg/ml, p = 0.029) hours after CPB. There were no differences in IL-8 or blood transfusion volume after CPB. Mini-CPB offers an alternative to conventional CPB for AVR and has some advantages regarding hemodilution and serum IL-6 levels. However, it is unlikely to become the standard approach for AVR because there are no marked clinical advantages of mini-CPB.
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Masataka
authors.initials: M
authors.lastname: Mitsuno
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yamamura
authors.forename: Hiroe
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ryomoto
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukui
authors.forename: Noriko
authors.initials: N
authors.lastname: Tsujiya
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kajiyama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis; D006438:Hemodilution; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D013995:Time
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8