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Eur J Cardiothorac Surg 2007;31:1070-1075. doi:10.1016/j.ejcts.2007.01.065
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Clinical advantages of using mini-bypass systems in terms of blood product use, postoperative bleeding and air entrainment: an in vivo clinical perspective

Cardiovascular Center Bad Bevensen, Clinic for Cardiac and Thoracic Surgery, Bad Bevensen, Germany

Received 21 September 2006; received in revised form 18 January 2007; accepted 31 January 2007.

^_* Corresponding author. Address: Klinik für Herz-Thorax-Chirurgie, Herz- und Gefäßzentrum Bad Bevensen, Roemstedter Str. 25, 29549 Bad Bevensen, Germany. Tel.: +49 5821 82 1702; fax: +49 5821 82 1777. (Email: m.perthel{at}hgz-bb.de).

Objective: In an effort to minimize the effect of extracorporeal circulation (ECC), mini-bypass is gaining clinical acceptance in routine coronary artery bypass grafting (CABG). These small circuits target combine the clinical advantages of reduced prime, 100% bio-coating and suction blood separation. We demonstrate that the use of mini-bypass in routine CABG reduces homologous blood product use and postoperative bleeding. Our goal was to also demonstrate that these small systems are effective in gaseous microemboli (GME) management as compared to a conventional extracorporeal system. Methods: Prospective, randomized study comparing 30 mini-bypass (Dideco ECC.O^TM) to 30 conventional systems (n = 30, Dideco 903 Avant^TM). Study included CABG cases only, independent of preoperative coagulative status; clinic ethical committee approval and informed patient consent was obtained before initiating study. Results: There were no statistical differences in terms of patient demographics. Statistically significant differences were seen in transfusion frequency (27% of the study group vs 43% in the control group, p = 0.05), transfused volume (133.3 ± 244.5 ml vs 325 ± 483.1 ml, p < 0.05), fresh frozen plasma (0 unit vs 3 units, p < 0.001), postoperative bleeding (301.8 ± 531.9 ml vs 785.5 ± 1000.4 ml, p < 0.05) and GME activity post-arterial filter (0.14 µl vs 5.32 µl, p < 0.05). Conclusions: The adoption of mini-bypass significantly potentially reduces hemodilution, donor blood usage, postoperative bleeding and exposure to GME in routine CABG patients as compared to the use of conventional extracorporeal circulation circuits.

Key Words: Cardiopulmonary bypass • Low prime • Venous air • Air removal

This article has been cited by other articles:

				M. Perthel, L. El-Ayoubi, A. Bendisch, J. Laas, and M. Gerigk Corrigendum to "Clinical advantages of using mini-bypass systems in terms of blood product use, postoperative bleeding and air entrainment: an in vivo clinical perspective" [Eur. J. Cardiothorac. Surg. 31 (2007) 1070 1075] Eur. J. Cardiothorac. Surg., December 1, 2007; 32(6): 952 - 952. [Full Text] [PDF]