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DOI: 10.1055/s-0032-1332265
Comparison of two different minimized extracorporeal circulation systems in reference to conventional cardiopulmonary bypass in patients with isolated coronary artery bypass surgery
Objective: In the last decade the minimized extracorporeal circulation (ECC) system has established in coronary artery bypass grafting. A reduction in systemic inflammatory markers and blood transfusion rate as well as lower 30-day mortality rates and lower incidences of atrial fibrillation were reported. The aim of our study was to evaluate the clinical outcome of two different ECC systems.
Methods: 1980 patients underwent isolated coronary artery bypass grafting between 04/07 and 12/11 and were compared retrospectively. Emergent cases were excluded from study. 1557 patients (370 female, 1187 male, mean age: 66.7 ± 9.7yrs) were operated with conventional cardiopulmonary bypass (cCPB) and 423 patients (81 female, 342 male, mean age: 67.6 ± 10.8yrs) were operated with ECC. In 56.7% the ECC.O (Dideco) and in 43.2% the RocSafe (Terumo) system was used in the ECC-group. The log EuroScores were similar between the two groups (5.0 ± 6.1 vs. 5.3 ± 6.4; p = 0.8).
Results: Between the two ECC systems we did not observed a statistically significant difference in the intra- and postoperative red blood cell transfusion rate (p = 0.3) as well as in the ventilation time (p = 0.42), length of intensive care unit stay (p = 0.4), re-exploration for bleeding (p = 0.2), neurological disorders (p = 0.9), postoperative stay (p = 0.9) or 30-day mortality rate (p = 0.8). But in the ECC group the red blood cell requirement (p < 0.001), the ventilation time (p < 0.001), length of intensive care unit stay (p = 0.02) and re-exploration for bleeding (p = 0.001) was significantly reduced compared to cCPB. No statistically significance was observed in the 30-day mortality rate (p = 0.05), neurological disorders (p = 0.18) and postoperative stay (p = 0.06).
Conclusion: The comparison of two different ECC systems did not show a statistically significant difference in clinical outcome, but are superior to cCPB in terms of red blood cell transfusion rate, ventilation time, length of intensive care unit stay and re-exploration for bleeding.