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DOI: 10.1055/s-0029-1191564
Minimized extracorporeal circulation in coronary artery bypass grafting: a 10 year single center experience
Aims: Coronary artery bypass grafting (CABG) with extracorporeal circulation (ECC) is the gold standard in heart surgery. We report on our experience, using minimized extracorporeal circulation (MECC) for multi-vessel CABG.
Method: Between 01/1998 and 09/2008, n=6229 patients underwent CABG supported by MECC and ECC. Urgent, redo and emergency CABG were excluded for our analysis. MECC (n=1447) was compared to standard ECC (n=3134) in the same time period. Both groups did not differ according to age (MECC: 66.9±8.9; ECC: 66.4±8.5p>0.05), left ventricular function, co-morbidity and logisticEuroScore (MECC: 3.8 [1.6;4.5]%; ECC: 3.8 [1.6;4.5]% p>0.05).
Results: Overall in hospital mortality rate was significant lower in the MECC compared to the ECC group (MECC: 2.0%; ECC: 3.6%. p<0.05). Circulatory support was lower and significant less patients were dependent on postoperative dialysis in the MECC group (MECC: 2.3d; ECC: 8.1d p<0.05). Though preoperative haemoglobin values and the postoperative drainage loss were not significant different, the average number of administrated packed red blood cells was lower (MECC: 1.5; ECC: 1.8p>0.05) after MECC. Postoperative ventilation time (MECC: 21.9h ECC: 28.5h p<0.05) was significantly shorter after MECC, whereas in hospital stay (MECC: 12d; ECC: 12.8d p>0.05) was not significantly lower in the MECC group.
Discussion: Our retrospective analysis showed lower in-hospital mortality, better renal function, less blood transfusions and shorter ventilation time after MECC revascularisation. In our opinion, MECC is superior to standard ECC for CABG surgery.