Methods: Twenty-eight patients (24 males, 4 females; mean age 62±12 years; range 41 to 84 years) who underwent elective CABG due to ischemic heart disease were enrolled in this single-blind prospective study with the odd-even number of randomization method. Phosphorylcholine-coated ECC systems were used in group 1 and non-coated ECC systems were used in group 2. The percentage of the coagulation factor activations [factor (F)-II, F-V, F-VII, F-VIII, F-X, F-XII, and von Willebrand factor], D-dimmer, and anti-thrombin III levels were measured preoperatively, intraoperatively and postoperatively.

Results: The percentage of activation of F-II and F-X in group 1 were significantly higher than group 2 before the cross-clamp removal (T1) (p<0.05). The percentage of activation of factor XII after surgery (six hours later-T3, postoperative first week-T4) increased in both groups, however, this increase was significantly higher in group 2 than group 1 (p<0.01). D-Dimer levels gradually increased in both groups and remained significantly higher (p<0.001), however, no difference was observed between the groups. The antithrombin III activity significantly reduced in both groups at T1 compared to the baseline values (T0) (p<0.01). The von Willebrand factor activity increased significantly in both groups at T1 and after termination of cardiopulmonary bypass (T2) (p<0.01), indicating no significant difference between the two groups (p>0.05).

Conclusion: Although the percentage of activation of the factors is higher in non-coated ECC systems compared to PC-coated ECC systems, it does not indicate significant clinical differences. In addition, both PC-coated or non-coated ECC systems exert similar biological effects during cardiopulmonary bypass.