Heparin-coated bypass circuits (Carmeda) suppress the release of tissue plasminogen activator during normothermic coronary artery bypass graft surgery

B. D. Spiess, C. Vocelka, R. P. Cochran, L. Soltow, Wayne Chandler

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objectives: To study fibrinolysis in a homogenous first-time coronary artery bypass surgery (CABG) population in whom heparin-coated circuits were used. Design: A prospective, blinded, randomized, placebo-controlled study. Setting: A university hospital, tertiary care, intraoperative and postoperative intensive care unit. Participants: Twenty-one adult elective primary CABG patients. Interventions: Randomized circuit-type centrifugal pump, membrane oxygenator, rigid cardiotomy reservoir, either placebo (n = 10) or heparin-coated (n = 11) (Carmeda; Medtronic Inc., Anaheim, CA). Measurement and Main Results: Blood samples were analyzed for tissue plasminogen activator (TPA) activity, TPA antigen, plasminogen activator inhibitor-1 (PAI-1) activity, prothrombin complex F1.2, and antithrombin III (AT-III) at the following times: before cardiopulmonary bypass (CPB), during CPB (30 and 60 minutes), post-CPB, and day 1 postsurgery. TPA activity and antigen increased fivefold in the placebo group during CPB, whereas it did not even double in the heparin-coated group. PAI-1, F1.2, and AT-III were not different between groups. Conclusions: Heparin-coated CPB circuits reduced TPA release in this homogenous CABG population with routine heparin/protamine management.

Original languageEnglish (US)
Pages (from-to)299-304
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume12
Issue number3
DOIs
StatePublished - Jan 1 1998

Keywords

  • Cardiopulmonary bypass
  • Coagulation
  • Coronary artery bypass graft surgery
  • Fibrinolysis
  • Heparin-coated circuit
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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