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Ann Thorac Surg 2008;86:1723. doi:10.1016/j.athoracsur.2008.06.012
© 2008 The Society of Thoracic Surgeons
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Correspondence

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Bertrand Marcheix, MD, Michel Carrier, MD

Department of Cardiac Surgery, Montreal Heart Institute, 5000 rue Belanger East, Montreal, Quebec, H1T 1C8 Canada

(Email: bmarcheix{at}wanadoo.fr).

To the Editor:

We appreciate the concerns of Hoedemaekers and colleagues [1] regarding our work [2].

The aim of our prospective randomized study was to determine whether the use of a cell saver device (CS) and vacuum-assisted venous return (VACPB) decreased the postoperative inflammatory response with a specific focus on the implication of the three complement pathways. Even if Bruins and colleagues [3] showed that complement activation after cardiopulmonary bypass (CPB) follows a biphasic pattern during the first 24 hours, we limited our study to the first 4 hours after weaning from CPB.

From a statistical point of view, we showed that the use of CS to process pericardial blood reduced activation of the alternative pathway, with lower levels of Bb 4 hours after weaning from CPB. In the conclusion, we underlined the limitation of our work and the potential interest of further study to determine the real clinical impact of these biological effects. The study of the kinetic activation of the three complement pathways within the first 24 hours could be another point of interest.


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  1. Hoedemaekers CW, van Deuren M, van der Hoeven JG. Complement activation after cardiac surgery follows a biphasic pattern(letter) Ann Thorac Surg 2008;86:1723.[Free Full Text]
  2. Marcheix B, Carrier M, Martel C, et al. Effect of pericardial blood processing on postoperative inflammation and the complement pathways Ann Thorac Surg 2008;85:530-535.[Abstract/Free Full Text]
  3. Bruins P, te Velthuis H, Yazdanbakhsh AP, et al. Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C-reactive protein and is associated with postoperative arrhythmia Circulation 1997;96:3542-3548.[Abstract/Free Full Text]

Related Article

Complement Activation After Cardiac Surgery Follows a Biphasic Pattern
Cornelia W. Hoedemaekers, Marcel van Deuren, and Johannes G. van der Hoeven
Ann. Thorac. Surg. 2008 86: 1723. [Extract] [Full Text] [PDF]




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