ABSTRACT
Background: In this study, we shared our experience with the minimal invasive extracorporeal circulation system for coronary artery bypass grafting patients. Methods: A total of 163 patients were included in the retrospective study, with 83 patients (63 males, 20 females; mean age: 61.9±8.9 years; range, 35 to 81 years) undergoing coronary artery bypass grafting with minimal invasive extracorporeal circulation and 80 patients (65 males, 15 females; mean age: 60.5±8.8 years; range, 43 to 82 years) undergoing coronary artery bypass grafting with conventional cardiopulmonary bypass between July 2021 and April 2023. Elective coronary bypass performed by same surgical team were included in the study. Mortality, major adverse cardiac and cerebrovascular event, hospital stays and transfusion requirements were evaluated. Results: There were no significant differences in sex distribution, age, comorbidities, and blood values between the two groups. Intraoperatively, the minimal invasive extracorporeal circulation group had a slightly higher number of distal anastomoses and comparable times for aortic cross-clamp and cardiopulmonary bypass. Postoperative outcomes such as tamponade, bleeding, atrial fibrillation, left ventricular ejection fraction improvement or reduction, and postoperative drainage were similar between the two groups. However, the minimal invasive extracorporeal circulation group had fewer transfusions of packed red blood cells and fresh frozen plasma and a shorter length of stay in the intensive care unit. Conclusion: The minimal invasive extracorporeal circulation system effectively preserves blood, works with lower activated clotting time values without additional complications in coronary artery bypass grafting, and could present a better option for patients with anemia or patients with a relatively high risk for high-dose heparinization.
ABSTRACT
BACKGROUND: In cardiac surgery, systemic venous drainage is provided by gravity. During the procedure, the amount of venous drainage can be increased by using a vacuum-assisted venous drainage (VAVD) technique. The purpose of this study is to compare the effects of VAVD and gravitational drainage (GD) techniques on hemolysis. METHODS: Totally, 60 patients were included in the study. The patients were separated into three groups, and each group designed with 20 patients: Groups are defined as Group 1 (-40 mmHg VAVD), Group 2 (-60 mmHg VAVD), and Group 3 (GD). Preoperative and postoperative values of lactate dehydrogenase (LDH), haptoglobin (Hpt), mean platelet volume (MVP), and platelet count (Plt) were evaluated. RESULTS: The duration of cardiopulmonary bypass, cross-clamp, and vacuum assistance times were similar in all groups (P > 0.05), whereas Group GD required more additional volume to maintain adequate perfusion (P = 0.034). Preoperative and postoperative measurements showed no significant difference in terms of LDH, MVP, Plt, and Hpt among the groups (P > 0.05). CONCLUSION: There was no significant increase in hemolysis among the groups, which demonstrates that the VAVD technique, even if lower negative pressure is preferred, can be applied safely and effectively to improve venous drainage and consequently, cardiac decompression, even if smaller venous cannulas are used, and also avoid from superfluous fluid addition to sustain adequate extracorporeal perfusion.
