ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Phosphorylcholine-coated extracoporeal circulation systems affect coagulation factors during cardiopulmonary bypass insufficiently: a preliminary report
Kadir Çeviker1, Mustafa Canikoğlu2, Ali Can Hatemi3, Ayşem Kaya4, Gürkan Çetin3, Kamil Karaoğlu5, Zafer Başlar6, Ali Murat Mert4, Şahin Şahinalp1
İstanbul University Institute of Cardiology, İstanbul, Turkey
1Department of Cardiovascular Surgery, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
2Department of Cardiovascular Surgery, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
3Departments of Biochemistry Laboratory, İstanbul University Institute of Cardiology, İstanbul, Turkey
4Departments of Cardiovascular Surgery, İstanbul University Institute of Cardiology, İstanbul, Turkey
5Departments of Anaesthesiology and Reanimation, İstanbul University Institute of Cardiology, İstanbul, Turkey
6Department of Hematology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.8727
Background: This study aims to investigate the efficacy of the phosphorylcholine (PC)-coated extracorporeal circulation (ECC) circuits compared to the non-coated ECC circuits in patients undergoing isolated coronary artery bypass grafting (CABG).

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.

Keywords : Blood coagulation factor; extracorporeal circulation; hemocompatibility; phosphorylcholine
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