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Ann Thorac Surg 1994;57:815-819
© 1994 The Society of Thoracic Surgeons

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Articles

Safe use of heparin-coated bypass circuits incorporating a pump-oxygenator

Department of Surgery, West Virginia University, Morgantown, West Virginia, USA

^_* Address reprint requests to Dr Hill, Department of Surgery, West Virginia University School of Medicine, Room 4060 HSCN, PO Box 9238, Moigantown, WV 26506-9238.

Durable, covalently bonded, heparin-coated cardiopulmonary bypass (CPB) circuits with oxygenators have been developed. Proposed advantages of heparin-coated CPB circuits include improved biocompatibility and thromboresistance. The purpose of this study was to evaluate our experience with heparin-coated CPB circuits in 20 patients. Heparin was given to maintain an activated clotting time equal to or greater than 200 seconds, while flow rates were kept equal to or greater than 2 L/min. Indications for use of this circuit included recent stroke, posttraumatic injuries, recent gastrointestinal bleeding, protamine allergies, combined cardiac and noncardiac procedures, and ventricular assist. Mean heparin dosage was 0.50 ± 0.18 mg/kg and protamine dosage was 57.14 ± 39.36 mg. Postoperative blood loss and transfusion requirements were minimal. Postoperative complement levels of C3a and C5a were normal, suggesting excellent biocompatibility. There were no deaths or perioperative complications. Heparin-coated CPB circuits using a pump oxygenator can be used safely with low-dose heparin administration in select patients requiring CPB.

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