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Ann Thorac Surg 2009;87:766-772. doi:10.1016/j.athoracsur.2008.11.050
© 2009 The Society of Thoracic Surgeons
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Karsten Wiebe
Leopold Rupprecht
Stephan Hirt
Claudius Diez
Michael Hilker
Christof Schmid
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Right arrow Extracorporeal circulation

Original Articles: Adult Cardiac

Minimal Extracorporeal Circulation: An Alternative for On-Pump and Off-Pump Coronary Revascularization

Thomas Puehler, MD*, Assad Haneya, Alois Philipp, Karsten Wiebe, MD, Andreas Keyser, MD, Leopold Rupprecht, MD, Stephan Hirt, MD, Reinhard Kobuch, MD, Claudius Diez, MD, Michael Hilker, MD, Christof Schmid, MD

Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany

Accepted for publication November 17, 2008.

* Address correspondence to Dr Puehler, Department of Cardiothoracic Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg, D-93053, Germany (Email: thomas.puehler{at}klinik.uni-regensburg.de).

Background: Coronary artery bypass surgery employing minimal extracorporeal circulation (MECC) was compared with standard extracorporeal circulation (ECC) and off-pump coronary artery bypass graft surgery (OPCABG) with regard to the perioperative course.

Methods: From January 2004 to December 2007, 1,674 patients (n = 558 MECC, n = 558 ECC, n = 558 OPCABG) who underwent coronary bypass surgery were studied. The primary end point was in-hospital mortality; secondary end points were perioperative variables, intensive care, and in-hospital course.

Results: Demographic data, comorbidity, and the European System for Cardiac Operative Risk Evaluation score (MECC 3.0%, ECC 3.5%, OPCABG 3.2%) were similar among the groups, but in-hospital mortality for elective and urgent/emergent patients was lower in the MECC and OPCABG groups (MECC 3.2%, OPCABG 3.7%, ECC 6.9%; p < 0.05). The number of distal anastomoses was lowest in the OPCABG group, but comparable for MECC and ECC patients. Postoperative ventilation time, release of creatinine kinase, catecholamine therapy, drainage loss, and transfusion requirements were lower in the MECC and OPCABG groups, whereas stay in the intensive care unit was shorter only in the latter (p < 0.05).

Conclusions: Minimal extracorporeal circulation is an easy and safe procedure for coronary artery bypass graft surgery. In selected patients, the advantages of MECC equal those of OPCABG. MECC should be considered as an alternative to OPCABG and standard ECC procedures.




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Home page
 Eur. J. Cardiothorac. Surg.Home page
A. Haneya, A. Philipp, C. Schmid, C. Diez, R. Kobuch, S. Hirt, W. Zink, and T. Puehler
Minimised versus conventional cardiopulmonary bypass: outcome of high-risk patients
Eur. J. Cardiothorac. Surg., November 1, 2009; 36(5): 844 - 848.
[Abstract] [Full Text] [PDF]


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