PMID: 8969375Sep 1, 1996Paper

Enhanced blood conservation and improved clinical outcome after valve surgery using heparin-bonded cardiopulmonary bypass circuits

Journal of Cardiac Surgery
O M ShapiraR J Shemin

Abstract

Recently, heparin-bonded (HBC) cardiopulmonary bypass circuits (CPB) were formed to be associated with improved outcome after coronary artery bypass grafting. There are very few reports on the efficacy and safety of these circuits in valve surgery. A retrospective cohort study of all patient populations undergoing first time valve surgery from 1992 to 1995 in a tertiary teaching hospital. Outcomes of 120 patients undergoing valve surgery using HBC and lower anticoagulation HBC were compared to 232 patients treated with conventional circuits and full heparinization (nonheparin-bonded-circuit [NHBC]). Postoperative 24-hour chest tube drainage (558 +/- 466 mL vs 1054 +/- 911 mL, p < 0.00001), and reoperation for bleeding (2.5% vs 8.2%, p = 0.04) were lower in the HBC group. HBC patients required significantly less transfusions (total donor exposure of 6.9 +/- 13.0 units vs 18.6 +/- 26.2 units, p < 0.00001). Multiple linear regression analysis identified CPB time as a predictor of increased homologous blood transfusions, and the use of HBC, a large body surface area, and elective procedure as predictors of decreased transfusions. Perioperative mortality was similar (HBC 2.5%, NHBC 4.7%, p = 0.24). Overall complications were lower i...Continue Reading

References

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Citations

May 13, 1999·The Annals of Thoracic Surgery·O M ShapiraR J Shemin
Dec 17, 1998·Journal of Cardiothoracic and Vascular Anesthesia·L Shore-Lesserson
Oct 20, 1999·Journal of Cardiothoracic and Vascular Anesthesia·B M Weiss, L K von Segesser
Aug 4, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Gregory A NuttallHartzell V Schaff
Jul 6, 2005·Thrombosis Research·Michael J EissesWayne L Chandler
Aug 6, 2002·Journal of Biomaterials Science. Polymer Edition·F D Rubens
Aug 14, 2012·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Soroosh KianiRobert S Poston

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