Clinical evaluation of totally heparin-coated cardiopulmonary bypass circuits on coagulation, fibrinolysis, platelets, and complement system

• Published in: Jinko Zoki Vol. 26; no. 6; pp. 990 - 996
• Main Author: KOKUBO, J
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR ARTIFICIAL ORGANS 1997; 一般社団法人 日本人工臓器学会
• Subjects: biocompatibility; heparin-coated cardiopulmonary bypass circuits; PAI-1; surface electron microscope; TAT
• ISSN: 0300-0818; 1883-6097
• DOI: 10.11392/jsao1972.26.990

To assess the biocompatibility of covalently-bonded, heparin-coated, cardiopulmonary bypass circuits (CPB), we compared a control CPB group (C group) with a heparin-coated CPB (H group) in elective CABG operations. Method: Fourteen patients who underwent CABG were randomly divided between the C group (n=7) and the H group (n=7). The CPB circuits included a membrane oxygenator (Maxima) and a centrifugal pump (Biopump). In the H group, heparin (3mg/kg) was administered to maintain an activated clotting time (ACT) greater than 480s. Measurements of blood samples were taken both preoperatively and during CPB to assess the values of the following: thrombin-antithrombin III complex (TAT), fibrinogen, antithrombin (AT)-III, plasminogen activator inhibitor-1 (PAT-1), α2-plasmin inhibitor plasmin complex (PIC), fibrinogen degradation product (FDP), fibrinopeptide Bβ15-42, C3, C4, β-thromboglobulin, platelet factor IV, 6-keto-PGF1β, thromboxane B2, myeloperoxidase, and free hemoglobin. Also, morphologic examinations of platelets on the surface of CPB circuits were performed, using a scanning electron microscope (SEM). Results: Compared with the C group, the H group showed significant suppression of the titers in TAT and PAT-1 (p<0.013 and p<0.019, respectively). The SEM survey also revealed significant suppression of morphologic changes in surfaceadhesive platelets in the H group. Conclusions: Considering biocompatibility in open heart surgery, some values of coagulation, fibrinolysis, and platelet activation were found to be preferable in heparin-coated CPB.