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Ann Thorac Surg 1999;67:994-1000
© 1999 The Society of Thoracic Surgeons
a San Donato Hospital, Milan, Italy
b University Hospital, Verona, Italy
c Policlinico Sant’Orsola, Bologna, Italy
d San Raffaele Hospital, Milan, Italy
e S. Maria della Misericordia Hospital, Udine, Italy
f Ospedale di Circolo, Varese, Italy
g Hesperia Hospital, Modena, Italy
h San Bortolo Hospital, Vicenza, Italy
i Sant’ Ambrogio Hospital, Milan, Italy
j Policlinico Le Scotte, Siena, Italy
k Ospedale Civili, Brescia, Italy
l S. Maria della Misericordia Hospital, Perugia, Italy
Accepted for publication September 23, 1998.
Address reprint requests to Dr Ranucci, Cardiovascular Center E. Malan, San Donato Hospital, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
Background. Heparin-coated circuits (HCCs) in low-risk cardiac patients who have coronary revascularization have a limited impact on postoperative outcome. In this prospective, randomized investigation, we studied high-risk patients who had cardiac operations with or without HCCs.
Methods. A total of 886 patients who had cardiac operations with cardiopulmonary bypass and at least one patient-related or procedure-related risk factor were enrolled in a multicenter study. They were randomly allocated to have cardiopulmonary bypass with Duraflo II HCCs (HCC group, n = 442) or conventional circuits (control group, n = 444). Postoperative outcome was investigated with respect to the occurrence of organ dysfunction.
Results. HCCs are associated with a shorter intensive care unit and postoperative hospital stay and with a lower rate of patients having a severely impaired clinical outcome (stay in intensive care unit for more than 5 days or death) (relative risk 0.66, p = 0.045). Lung dysfunction rate was significantly lower for the patients in HCC group affected by chronic obstructive pulmonary disease or who had mitral procedure (relative risk, respectively, 0.31, p = 0.018 and 0.05, p = 0.02). Renal dysfunction rate was significantly (p = 0.05) lower for diabetics in the HCC group (relative risk 0.28).
Conclusions. When HCCs were used postoperative times decreased and they had a protective effect on lung and kidney function in high-risk patients.
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Ann. Thorac. Surg. 1999 67: 1000.
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