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Ann Thorac Surg 1999;67:689-696
© 1999 The Society of Thoracic Surgeons
a Cardiac Surgery University of Ottawa Heart Institute, Ottawa, Ontario, Canada
b Cardiac Anaesthesia, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
Accepted for publication August 21, 1998.
Address reprint requests to Dr Rubens, Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON, K1Y 4W7 Canada
e-mail: frubens{at}heartinst.on.ca
Background. To decrease the complications associated with cardiopulmonary bypass, novel biomaterials have been introduced that may be less thrombogenic than standard synthetic surfaces.
Methods. Thirty-four patients undergoing coronary artery bypass grafting were randomized to bypass using either a control circuit or a circuit prepared "tip-to-tip" with a triblock-copolymer (polycaprolactone-polydimethylsiloxane-polycaprolactone).
Results. There was a progressive increase in thrombin generation in the control group during bypass, which was not seen in the test group. The test surface decreased the release of tissue plasminogen activator and plasmin-
2-antiplasmin complex formation (p < 0.005). There was also an increased platelet count and a decreased platelet activation in the test group, as detected by GMP-140 expression and ß-thromboglobulin release (p = 0.017). There was also significantly more debris that accumulated on the arterial filter in the control group, as confirmed by scanning electron microscopy.
Conclusions. This clinical trial has demonstrated a significant difference in the hematologic effects of the test circuits, with evidence of platelet preservation, decreased fibrinolysis, and decreased thrombin generation. A larger trial would be necessary to establish the clinical relevance of these differences.
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Ann. Thorac. Surg. 1999 67: 696-697.
Ann. Thorac. Surg. 1999 67: 697-698.
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