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Eur J Cardiothorac Surg 2001;19:47-53
© 2001 Elsevier Science NL

Neurological and general outcome in low-risk coronary artery bypass patients using heparin coated circuits

Department of Surgery and Perioperative Science, University of Ume, Ume, Sweden

Received 18 September 2000; received in revised form 9 November 2000; accepted 10 November 2000.

Corresponding author. Heart Centre, University Hospital of Ume, S-901 85 Ume, Sweden. Tel.: +46-90-7853650; fax: +46-90-7853601
e-mail: staffan.svenmarker.us{at}v11.se

Objective: The clinical significance of heparin coating in cardiopulmonary bypass has previously been investigated. However, few studies have addressed the possible influence on brain function and memory disturbances. Methods: Three hundred low-risk patients exposed to coronary bypass surgery were randomised into three groups according to type of heparin coating: Carmeda Bioactive Surface, Baxter Duraflo II and a control group. Outcome was determined from a number of clinically oriented parameters, including a detailed registry of postoperative deviations from the normal postoperative course. Brain damage was assessed through S100 release and memory tests, including a questionnaire follow-up. Results: Clinical outcome was similar for all groups. Blood loss (Duraflo only), transfusion requirements and postoperative creatinine elevation were reduced in the heparin-coated groups. A lower incidence of atrial fibrillation was noted in the Duraflo group. Heparin coating did not uniformly attenuate the release of S100 or the degree of memory impairment. Conclusions: Cardiopulmonary bypass (CPB) with heparin coating and a reduced dose of heparin seems to be safe. Clinical outcome and neurological injury seem not to be associated with type of heparin coating used for CPB. However, blood loss and transfusion requirements may be reduced.

Key Words: Heparin • S100-beta • Blood loss • Memory • Cardiopulmonary bypass

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