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Francesco Nicolini
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Alessandro Maria Budillon
Tiziano Gherli
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Ann Thorac Surg 2006;81:1396-1400
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Mini–Cardiopulmonary Bypass System: Results of a Prospective Randomized Study

Cesare Beghi, MDa, Francesco Nicolini, MDa,*, Andrea Agostinelli, MDa, Bruno Borrello, MDa, Alessandro Maria Budillon, MDa, Franco Bacciottini, MDb, Marco Friggeri, MDb, Antonietta Costa, MDc, Loredana Belli, MDc, Luisita Battistelli, MDd, Tiziano Gherli, MDa

a Department of Cardiac Surgery, University of Parma, Italy
b Department of Experimental Medicine, University of Parma, Italy
c Department of Anesthesiology, University of Parma, Italy
d Biochemical Analysis Laboratory, Ospedale Maggiore of Parma, Parma, Italy

Accepted for publication October 17, 2005.

* Address correspondence to Dr Nicolini, Cattedra e Divisione di Cardiochirurgia, Università degli Studi, Via A. Gramsci 14, Parma 43100, Italy (Email: francesconicolini{at}libero.it).

Background: We studied postoperative mortality and morbidity after coronary artery bypass graft surgery performed using the mini–extracorporeal circulation (MECC) system.

Methods: From June 2001 to June 2002, we randomly enrolled 60 patients who underwent isolated elective coronary artery bypass graft surgery, and were operated on with the MECC system (30 patients: group A) or standard cardiopulmonary bypass (30 patients: group B). Serial blood samples were collected to evaluate the main preoperative, intraoperative, and postoperative clinical and biological variables; and to measure hemolysis, interleukin-6 cytokine, and plasma C-reactive protein release.

Results: A more stable hemoglobin level was detected in group A. The platelet count did not show a significant difference between the two groups. Interleukin-6 cytokine release showed higher values in group B, although no difference between groups was statistically significant. The time course of circulating plasma C-reactive protein concentration exhibited the same increase in both groups. Plasma free hemoglobin levels showed higher hemolysis peaks in group B, although a statistical significant difference was detected only at 4 hours after surgery. A higher cardiac index and reduced systemic and pulmonary vascular resistance index in the early postoperative period were found in group A at postoperative time 30 minutes.

Conclusions: Our experience shows that MECC offers satisfactory clinical benefits in terms of good hemodynamic support, safety, and low morbidity, although the study failed to demonstrate a significant clear superiority of MECC versus conventional cardiopulmonary bypass. The results need to be confirmed by a larger prospective, randomized study comparing MECC and standard cardiopulmonary bypass.




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