J Thorac Cardiovasc Surg 2003;125:S90-S91
© 2003 The American Association for Thoracic Surgery
Safety and efficacy of heparin-bonded surfaces in cardiopulmonary bypass
Ludwig K. von Segesser, MD, FETCS, FACS
From the Department for Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, Lausanne, Switzerland.
Received for publication Oct 2, 2002. Accepted for publication Oct 19, 2002.
Address for reprints: L. K. von Segesser, MD, FETCS, FACS, Department for Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland (E-mail: Ludwig.von-Segesser@chuv.hospvd.ch).
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The first article on heparin surface bonding was published in 1963 by Gott, Whiffen, and Datton.
1 At that time, the development of blood-exposed surfaces with improved thromboresistance was of prime interest. In those days, device occlusion during cardiopulmonary bypass (CPB) was a current problem. The presence of a shunt line that allows the arterial filter to be bypassed in most CPB circuits is still a testament to this major weakness of perfusion. Fortunately, in the early days the arterial filters tended to thrombose before the heat exchangers and oxygenators, and bypassing them usually salvaged the procedure. However, increasing awareness of this problem led to the development of more thromboresistant arterial filters with a variety of heparin surface coatings. The success of these efforts opened the door for systematic application of heparin surface coatings for filter screens at various positions in the CPB circuit. Routine clinical use of heparin-coated components was thus established. The practice remained unrecognized for many years because CPB appeared to be extremely safe in conjunction with full systemic heparinization as defined by an activated coagulation time (ACT) of more . . . [Full Text of this Article]
Copyright © 2003 by The American Association for Thoracic Surgery.
