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Ann Thorac Surg 1998;66:1958-1962
© 1998 The Society of Thoracic Surgeons

Original Articles

Serum S100ß release after coronary artery bypass grafting: roller versus centrifugal pump

Saeed Ashraf, FRCSa, Kausik Bhattacharya, FRCSb, Sunny Zacharias, FRCSa, Pradeep Kaul, FRCSa, Philip H. Kay, DMa, Kevin G. Watterson, FRACSa

a Yorkshire Heart Centre, Leeds General Infirmary, Leeds, United Kingdom
b Oxford Heart Centre, John Radcliffe Hospital, Oxford, United Kingdom

Accepted for publication May 30, 1998.

Address reprint requests to Dr Ashraf, Leeds General Infirmary, Yorkshire Heart Centre, Leeds, LS1 3EX, UK

Background. Microemboli generated during cardiopulmonary bypass (CPB) are implicated in the cerebral injury seen after coronary artery bypass grafting. Centrifugal pumps generate fewer microemboli than roller pumps. Increased S100ß levels have been reported after coronary artery bypass grafting, with levels greater than 1 ng/mL resulting in poorer neuropsychologic outcome. This study investigated the potential neurologic benefits of centrifugal pumps, by using S100ß as a marker for cerebral injury.

Methods. Thirty-two patients who had coronary artery bypass grafting were randomly assigned to two groups. Serial blood samples (preoperative, end of bypass, 30 minutes, and 2 and 24 hours after cardiopulmonary bypass) were taken and the serum analyzed for S100ß using a new immunoluminometric assay.

Results. Both groups were matched for age, number of grafts, and cardiopulmonary bypass and cross-clamp times. Postoperative serum S100ß levels were significantly higher in both groups than preoperative levels. Peak S100ß levels did not correlate with cardiopulmonary bypass time; however, 24-hour S100ß levels correlated with intubation time r = 0.40, p = 0.04). There was no significant difference in S100ß levels between the groups at any of the time points.

Conclusions. S100ß levels increased after coronary artery bypass grafting. Centrifugal pumps do not significantly decrease S100ß release. Persistently increased S100ß levels are associated with longer intubation times.




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