Clinical experience with the mini-extracorporeal circulation system: an evolution or a revolution?

Rémadi, Jean-Paul; Marticho, Paul; Butoi, I.; Rakotoarivelo, Zava; Trojette, Faouzi; Benamar, A.; Béloucif, Sadek; Foure, Dominique; Poulain, H

doi:10.1016/s0003-4975(03)00977-9

Cited by 75 publications

(69 citation statements)

References 8 publications

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“…4,13 In a mixed cohort of coronary and valvular patients, MECC proved technically attainable, versatile, and reliable for full extracorporeal perfusion with satisfactory control of postoperative morbidity. 14 Randomized controlled experiences indicate that MECC is more biocompatible than standard CPB. 5 Some authors have noted no effect on 5-year cognitive and cardiac outcomes if CPB is avoided.…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Comparison of Coronary Bypass Grafting With Minimal Extracorporeal Circulation System (MECC) Versus Off-Pump Coronary Surgery

Mazzei¹,

Nasso²,

Salamone³

et al. 2007

Circulation

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Background-We aimed to evaluate the clinical results and biocompatibility of the minimal extracorporeal circulation system (MECC) compared with off-pump coronary revascularization (OPCABG). Methods and Results-In a prospective randomized study, 150 patients underwent coronary surgery with the use of MECC and 150 underwent OPCABG. End points were (1) circulating markers of inflammation and organ injury, (2) operative results, and (3) outcome at 1-year follow-up. Operative mortality and morbidity were comparable between the groups. Release of inflammatory markers was similar between groups at all time points (peak interleukin-6 167.2Ϯ13.5 versus 181Ϯ6.5 pg/mL, Pϭ0.14, OPCABG versus MECC group, respectively). Peak creatine kinase was 419.3Ϯ103.5 versus 326Ϯ84.2 mg/dL (Pϭ0.28), and peak S-100 protein was 0.13Ϯ0.08 versus 0.29Ϯ0.1 pg/mL (Pϭ0.058, OPCABG versus MECC group, respectively). Length of hospital stay and use of blood products were similar between groups. Two cases of angina recurrence at 1 year in the MECC group were observed versus 5 cases observed in the OPCABG group (Pϭ0.44). A residual perfusion defect at myocardial nuclear scan was less frequent among patients in the MECC group (3 versus 9 cases, Pϭ0.14; odds ratio 0.32, 95% confidence interval 0.07 to 1.32). Six (OPCABG group) versus 3 (MECC group) coronary grafts were occluded or severely stenotic at 1 year (Pϭ0.33, odds ratio 0.47, 95% confidence interval 0.09 to 2.14). Conclusions-Clinical results of coronary revascularization with MECC are optimal when this procedure is performed by experienced teams. Postoperative morbidity is comparable to that with OPCABG. MECC is associated with little pump-related systemic and organ injury. It may achieve the benefits of OPCABG (less morbidity in high-risk patients) while facilitating complete revascularization in the case of complex lesions unsuitable for OPCABG. (Circulation.

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Section: Discussionmentioning

confidence: 99%

Prospective Randomized Comparison of Coronary Bypass Grafting With Minimal Extracorporeal Circulation System (MECC) Versus Off-Pump Coronary Surgery

Mazzei¹,

Nasso²,

Salamone³

et al. 2007

Circulation

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“…During 'mini-CPB' procedures only 15% of patients required PRBC administration, and the total transfusion count was 30-50% less in comparison with classic CPB in different studies. This is of much importance in surgeries performed in Jehova's Witnesses [8]. Several studies have shown that any amount greater than 1 unit of PRBC transfused, regardless of the procedure performed, results in decreased life expectancy of the patient [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Mak¹,

Smolka

Kowalski

et al. 2016

Kardiol Pol

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A b s t r a c tBackground: Commonly used cardiopulmonary bypass systems with cardiotomy reservoir, oxygenator, and roller pump require preoperative crystalloid filling. Radical reduction of the filling fluid volume and replacing it with the patient's own blood has a fundamental impact on the outcome. Aim:A comparison of cardiopulmonary bypass filled with the patient's blood, applied in Poland for the first time, and the classical system filled with crystalloids.Methods: Non-randomised trial in which patients undergoing coronary artery bypass grafting were divided into two groups: first operated on with use of cardiopulmonary bypass system with the patient's own blood priming, and a control group operated on with standard technique. Levels of haemoglobin (HGB), haematocrit (HCT), platelets, leukocytes, creatinine, protein, C-reactive protein, procalcitonin, volume of transfused blood products, postoperative drain output, time to extubation, and consumption of catecholamines were compared. Results:The results of a study comparing the classical system with the blood-filled system (n = 60) showed a significantly smaller decrease in HGB and HCT levels (p = 0.001), resulting in reduction of blood product transfusions by 75% (p = 0.03). The new type of extracorporeal circulation reduced the total postoperative drain output by approximately 28% (p = 0.003). The systemic inflammatory response syndrome (SIRS) was less pronounced and the tissue perfusion was better due to smaller degree of haemodilution leading to better organ and heart protection. The patients required shorter mechanical ventilation times in the perioperative period. Conclusions:The use of a new system of cardiopulmonary bypass filled with the patient's blood reduces the postoperative decrease in HGB and HCT, the amount of transfused blood products, and total postoperative drain output. It also shortens the time spent on mechanical ventilatory support.

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“…1,2 The low-priming volume extracorporeal system has often been used in neonate cardiac surgery for Jehovah's Witnesses 8 and discussed in relation to adult cardiac surgery such as coronary artery bypass grafting. [9][10][11][12] The low-priming volume bypass system is recognized as safe and reliable 1,[9][10][11][12] and has even been reported to reduce postoperative infl ammation because there is less blood contact with foreign surfaces. 9 Pulmonary effusion is an important morbidity of the Fontan procedure.…”

Section: Discussionmentioning

confidence: 99%

Miniaturized biocompatible cardiopulmonary bypass for the Fontan procedure

et al. 2010

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Clinical experience with the mini-extracorporeal circulation system: an evolution or a revolution?

Cited by 75 publications

References 8 publications

Prospective Randomized Comparison of Coronary Bypass Grafting With Minimal Extracorporeal Circulation System (MECC) Versus Off-Pump Coronary Surgery

Prospective Randomized Comparison of Coronary Bypass Grafting With Minimal Extracorporeal Circulation System (MECC) Versus Off-Pump Coronary Surgery

Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

Miniaturized biocompatible cardiopulmonary bypass for the Fontan procedure

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