Minimally Invasive Closed Circuit Versus Standard Extracorporeal Circulation for Aortic Valve Replacement

Castiglioni, Alessandro; Verzini, Alessandro; Pappalardo, Federico; Colangelo, Nicola; Torracca, Lucia; Zangrillo, Alberto; Alfieri, Ottavio

doi:10.1016/j.athoracsur.2006.09.039

Cited by 60 publications

(46 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also, a lower inflammatory reaction (7,8), a reduction of red blood cells transfusions (8,9), a lower level of postoperative blood creatinine and urea (8), a lower number of microbubbles (10) and a less incidence of postoperative atrial fibrillation (11) has been demonstrated with different mini-extracorporeal circulation Mini-extracorporeal circulation systems have also been used successfully with aortic and mitral valve procedures (8). Recently positive clinical results have been reported with MECC system (Jostra AG, Hirrlingen, Germany) for aortic valve replacement (12) as regards blood transfusion requirements, platelets consumption and myocardial damage.…”

Section: Discussionmentioning

confidence: 93%

New mini-extracorporeal circulation system (ECC.O) is a safe technique in coronary surgery

Valtonen

Vähäsilta

Kaila-Keinänen

et al. 2007

Scandinavian Cardiovascular Journal

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 93%

New mini-extracorporeal circulation system (ECC.O) is a safe technique in coronary surgery

Valtonen

Vähäsilta

Kaila-Keinänen

et al. 2007

Scandinavian Cardiovascular Journal

View full text Add to dashboard Cite

show abstract

“…18,19) The influence of surgical team set-up in our trial on higher bleeding in group C seems to be inconsequential.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Blood Loss in Coronary Surgery No Real Impact of Fibrinolysis Detected by Thromboelastography and D-Dimers. A Prospective, Randomized Study

Snircova

Jares

Malý³

et al. 2008

Int. Heart J.

View full text Add to dashboard Cite

SUMMARYAlthough in many cardiac surgery centers pharmacological strategies based on fibrinolytic inhibitors are used on a routine basis, detailed knowledge of fibrinolysis during various settings of coronary surgery is still limited.Sixty-five patients scheduled for coronary surgery were randomized into 3 groups:group A -conventional coronary artery bypass grafting, group B -off-pump surgery, and group C -coronary artery bypass grafting with modified, rheoparin coated cardiopulmonary bypass with the avoidance of reinfusion of cardiotomy blood into the circuit. The sampling time points for rotation thromboelastographic evaluations were as follows: preoperatively, 15 minutes after sternotomy, on the completion of peripheral bypass anastomoses, at the end of the procedures, and 24 hours after the end of surgery. D-dimer levels were evaluated before surgery, at the end of procedures, and 24 hours after surgery. Thromboelastographic signs of fibrinolysis (evaluated by Lysis Onset Time-intergroup differences at 60 and 150 minutes of assessment: P = 0.003 and P < 0.001, respectively) were clearly detectable during cardiopulmonary bypass in group A, but not at any time in groups B and C. At the other sampling times all thromboelastographic parameters were similar in all groups. In group A, no exceptional bleeding tendency (during 24 hours), as compared to groups B and C (geometric means and 95% confidence intervals: group A: 686.7 [570.8; 826.1] mL, group B: 555.3 [441.3; 698.9] mL, group C: 775.6 [645.1; 932.3] mL, P = 0.157), and no significant correlations between Lysis Onset Time, postoperative blood loss, and D-dimer levels were found. No significant differences in postoperative blood loss related to cardiac surgeons and assistant surgeons were detected.Thromboelastographic signs of increased fibrinolysis were detectable in the important proportion of coronary surgery patients operated on with the use of conventional cardiopulmonary bypass, but not in off-pump patients and those operated on with the biocompatible surface-modified circuit without reinfusion of cardiotomy suction blood. These signs resolved spontaneously at the end of surgery and were not associated with increased postoperative bleeding. No significant correlation with D-dimer levels was found. (Int From the

show abstract

“…Other studies reporting on mini-CPB systems support these results. 17,19,32,36 Limitations In this study, all patients without the indicated exclusion criteria undergoing elective coronary artery bypass grafting were included. Because our hospital is a university center and surgical training is performed, these elective low-risk patients are operated by either experienced or inexperienced surgeons.…”

Section: Discussionmentioning

confidence: 99%

Prospective, Randomized Study Comparing Two Different Minimized versus Conventional Cardiopulmonary Bypass Systems

Schoenebeck¹,

Haddad²,

Wegscheider

et al. 2010

Innovations�(Phila)

View full text Add to dashboard Cite

Objective Conventional cardiopulmonary bypass (CCPB) is a major trigger of inflammatory response. We aimed to assess the impact of two different minimized cardiopulmonary bypass systems (mini-CPB) with and without Bioline-coating compared with CCPB regarding organ function, inflammatory response, and early clinical outcome. Methods In a prospective, randomized study, 120 patients underwent elective coronary artery bypass grafting and were randomized into three groups: mini-CPB using a Bioline-coated (group A, n = 40) or an uncoated (group B, n = 40) circuit, or CCPB (group C, n = 40). Cytokines (interleukin-6, interleukin-8, and tumor necrosis factor-alpha), myocardial markers (creatine kinase [CK], CK-MB, and troponin-T), hematocrit, and platelet counts were measured up to 48 hours postoperatively. Early clinical outcome was assessed at 3 months postoperatively. Results Demographics, number of distal anastomoses, ventilation time, blood loss, intensive care unit, and hospital stay were comparable (P = not significant). Extracorporeal circulation and cross-clamp time were significantly longer in group A and B versus C (P < 0.005). No significant differences could be found in the release of interleukin-6, interleukin-8, and tumor necrosis factor-alpha among groups. Myocardial markers were significantly reduced in group A and B versus group C (P < 0.001). Hematocrit and platelet counts did not differ among the groups. No differences could be found in early clinical outcome up to 3 months. Conclusions This study showed significant better myocardial preservation with lower CK-MB and troponin-T levels in both mini-CPB groups. No significant differences could be found in terms of inflammation, hematologic effects, and early clinical outcome.

show abstract

Minimally Invasive Closed Circuit Versus Standard Extracorporeal Circulation for Aortic Valve Replacement

Cited by 60 publications

References 30 publications

New mini-extracorporeal circulation system (ECC.O) is a safe technique in coronary surgery

New mini-extracorporeal circulation system (ECC.O) is a safe technique in coronary surgery

Postoperative Blood Loss in Coronary Surgery No Real Impact of Fibrinolysis Detected by Thromboelastography and D-Dimers. A Prospective, Randomized Study

Prospective, Randomized Study Comparing Two Different Minimized versus Conventional Cardiopulmonary Bypass Systems

Contact Info

Product

Resources

About