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Ann Thorac Surg 2006;81:1683-1690
© 2006 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Comparison of Inflammatory Responses After Off-Pump and On-Pump Coronary Surgery Using Surface Modifying Additives Circuit

^a Department of Surgery, Biostatistics, University of Liège, Liège, Belgium
^b Department of Sciences of Public Health, Biostatistics, University of Liège, Liège, Belgium

Accepted for publication November 3, 2005.

^_* Address correspondence to Dr Limet, Department of Cardiovascular Surgery, CHU de Liège, 4000 Liège, Belgium (Email: rlimet{at}ulg.ac.be).

BACKGROUND: Cardiac surgery is followed by various degrees of inflammation, which have harmful consequences. Because of the central role of extracorporeal circulation (EC), off-pump coronary bypass surgery is deemed preferable. Do different modalities of EC challenge this view?

METHODS: Four groups of similar patients underwent coronary surgery: (group 1) on-pump, EC with closed surface modifying additives (SMA) circuit and no pump suckers (n = 20); (group 2) on-pump, EC with open SMA circuit and pump suckers (n = 20); (group 3) off-pump (beating heart) and heparin 3 mg/kg (n = 20); (group 4) off-pump (beating heart) and heparin 1 mg/kg (n = 20). Interleukins (IL)-6, IL-8, IL-10, myeloperoxidase, elastase, and terminal complex of the complement (TCC) were analyzed at various times: at induction (time I); after heparin (time II); after complete revascularization (time III); after protamine (time IV); and 24 hours later (time V).

RESULTS: The TCC was significantly higher in groups 1 and 2 at time III. The pattern of IL-6 was the same for the four groups. No significant difference in myeloperoxydase content was noted; however, elastase was significantly higher in the two EC (on-pump) groups.

CONCLUSIONS: Except for the complement system and elastase, on-pump surgery with SMA-coated circuits did not elicit any greater inflammatory response than off-pump surgery.

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