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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 806-813, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Reduced complement activation with heparin-coated oxygenator and tubings in coronary bypass operations

V Videm, JL Svennevig, E Fosse, G Semb, A Osterud and TE Mollnes
University of Oslo Institute for Experimental Medical Research, Norway.

Complement activation after cardiopulmonary bypass is correlated with postoperative organ dysfunction. Heparin coating of the entire blood- contact surface of the cardiopulmonary bypass circuit has proved to reduce complement activation in vitro. A membrane oxygenator and tubing setup coated with functionally active heparin was compared with an uncoated, otherwise identical setup in 20 patients undergoing routine coronary bypass operations. The concentrations of C3 activation products and the terminal complement complex were measured in sensitive and specific enzyme immunoassays. Peak concentrations of C3 activation products were 90.1 (74.7 to 107.4) AU/ml (medians and 95% confidence intervals) and 52.4 (35.7 to 76.4) AU/ml with the uncoated and coated setups, respectively (p = 0.02). The corresponding concentrations of the terminal complement complex were 26.2 (20.1 to 37.5) AU/ml and 13.7 (11.1 to 25.1) AU/ml (p = 0.03). Blood loss from the mediastinal drains during the first 12 postoperative hours was 533 (416 to 975) ml in patients treated with the uncoated setup and 388 (313 to 579) ml in the coated treatment group (p = 0.06) and was significantly correlated with peak concentrations of the terminal complement complex (p = 0.01). There were no differences in neutrophil counts nor platelet numbers between the treatment groups. The approximate 45% reduction in complement activation with the heparin-coated cardiopulmonary bypass device indicates a substantial improvement of biocompatibility.


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J. Svennevig, S. Tollofsrud, U. Kongsgaard, H. Noddeland, B. Mohr, M. Ozer, and T. Mollnes
Complement activation during and after open-heart surgery is only marginally affected by the choice of fluid for volume replacement
Perfusion, January 1, 1996; 11(4): 326 - 332.
[Abstract] [PDF]

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A. Hamulu, B. Discigil, M. Ozbaran, T. Calkavur, E. Kara, A. Kokuludag, S. Buket, and O. Bilkay
Complement consumption during cardiopulmonary bypass: comparison of Duraflo II heparin-coated and uncoated circuits in fully heparinized patients
Perfusion, January 1, 1996; 11(4): 333 - 337.
[Abstract] [PDF]

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 Ann. Thorac. Surg.Home page
E. Ovrum, T. E. Mollnes, E. Fosse, E. A. Holen, G. Tangen, M.-A. L. Ringdal, and V. Videm
High and Low Heparin Dose With Heparin-Coated Cardiopulmonary Bypass: Activation of Complement and Granulocytes
Ann. Thorac. Surg., December 1, 1995; 60(6): 1755 - 1761.
[Abstract] [Full Text]

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 J. Thorac. Cardiovasc. Surg.Home page
E. Ovrum, T. E. Mollnes, E. Fosse, E. A. Holen, G. Tangen, M. Abdelnoor, M.-A. L. Ringdal, R. Oystese, and P. Venge
COMPLEMENT AND GRANULOCYTE ACTIVATION IN TWO DIFFERENT TYPES OF HEPARINIZED EXTRACORPOREAL CIRCUITS
J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1623 - 1632.
[Abstract] [Full Text]

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 Ann. Thorac. Surg.Home page
O. Moen, E. Fosse, V. Brockmeier, C. Andersson, T. E. Mollnes, K. Hogasen, and P. Venge
Disparity in Blood Activation by Two Different Heparin-Coated Cardiopulmonary Bypass Systems
Ann. Thorac. Surg., November 1, 1995; 60(5): 1317 - 1323.
[Abstract] [Full Text]

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 J. Thorac. Cardiovasc. Surg.Home page
P. G. M. Jansen, H. t. Velthuis, R. A. J. M. Huybregts, R. Paulus, E. R. Bulder, H. I. van der Spoel, P. D. Bezemer, E. H. Slaats, L. Eijsman, and C. R. H. Wildevuur
Reduced complement activation and improved postoperative performance after cardiopulmonary bypass with heparin-coated circuits
J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 829 - 834.
[Abstract] [Full Text]

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 J. Thorac. Cardiovasc. Surg.Home page
D. D. Muehrcke, P. M. McCarthy, R. W. Stewart, S. Seshagiri, D. A. Ogella, R. C. Foster, and D. M. Cosgrove
Complications of extracorporeal life support systems using heparin-bound surfaces: The risk of intracardiac clot formation
J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 843 - 851.
[Abstract] [Full Text]

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 Ann. Thorac. Surg.Home page
E. Ovrum, E. A. Holen, G. Tangen, F. Brosstad, M. Abdelnoor, M.-A. L. Ringdal, R. Oystese, and R. Istad
Completely Heparinized Cardiopulmonary Bypass and Reduced Systemic Heparin: Clinical and Hemostatic Effects
Ann. Thorac. Surg., August 1, 1995; 60(2): 365 - 371.
[Abstract] [Full Text]

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L. von Segesser, J. Schilling, B. Leskosek, K. Marquardt, and M. Turina
Surface treatments for perfusion devices
Perfusion, May 1, 1994; 9(3): 197 - 205.
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Z. A Varga
Autologous plateletpheresis in cardiac surgery
Perfusion, November 1, 1993; 8(6): 471 - 476.
[Abstract] [PDF]


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