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Suhara, H.; Sawa, Y.; Fukushima, N.; Nishimura, M.; Matsumiya, G.; Kagisaki, K.; Anzai, T.*; Yokoyama, K.*; Oshiyama, H.*; Matsuda, H.
Division of Cardiovascular Surgery, Osaka University
*Graduate School of Medicine and Terumo corporation, R&D
[Background] We have reported the efficacy of a new coating material, poly-2-methoxyethyl acrylate (PMEA) for cardiopulmonary bypass (CPB) circuit in porcine PCPS models. In this study, we evaluated the efficacy of PMEA coating (X coating®) in patients with open heart surgery. [Methods and Materials] Twenty-one patients underwent valve surgeries under X-coated CPB circuits (group X, n=5), non-coated circuits (group C, n=8) or heparin (ionically bound-heparin, Hepaface®)-coated circuits (group H, n=8). We analyzed the complement system, inflammatory system, platelet system and coagulofibrinolytic system in blood samples, after anesthesia induction, 10min after heparin administration, 30min after extracorporeal circulation establishment, 60min after protamine administration. We also examined plasma proteins adsorbed onto the hollow fibers of the oxygenators after CPB in each group. [Results] Platelet system: Platelet counts decreased gradually during CPB in all groups. There were no significant differences between 3 groups. The plasma levels of platelet factor 4 and P-selectin were lower in group X than in group C. Complement system: The elevations in plasma C3a levels were less in group X than in group C. They were equal to in group H. Coagulofibrinolytic system: The plasma levels of TAT complex and D-dimer were lower in group X than in group C. Inflammatory system: The plasma levels of IL-6 and IL-8 were lower in group X than group C. Adsorbed plasma proteins, especially fibrinogen were markedly less in group X than in group C and H. [Conclusion] In this clinical study, the superior biocompatibility of X-coating was confirmed as CPB coating material, and its efficacy seemed to be compatible to heparin coating as for various chemical reactions induced by CPB. In addition, it may exceed the heparin coating as for suppression of the adsorption of plasma proteins such as fibrinogen. X coating may be suitable for the improvement of biocompatibility of CPB in the clinical settings.
Copyright © 2001 by the American Society for Artificial Internal Organs
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