Articles of Interest

Cardiopulmonary bypass with heparin-coated perfusion circuits and reduced anticoagulation is a safe and effective method to improve clinical results in cardiac surgery. Svenmarker and colleagues randomized three hundred coronary artery bypass patients into three groups: Carmeda Bioactive Surface, Baxter Duraflo II and a control group. Outcomes were evaluated using clinical indicators while brain injury was studied using S100 release and memory tests. Blood loss (Duraflo only), transfusion requirements and postoperative creatinine elevation were lower in the heparincoated groups. No difference in clinical outcomes was noted between the three groups. Heparin-coated groups showed no advantage in S100 release or neurological impairment. In a similar paper, Ovrum et al randomize over 1300 patients in either Carmeda or Duraflo groups. Similar findings were noted as both groups showed no appreciable difference in clinical outcomes between the different coatings. Finally, Dr. von Segesser provides a good historical overview of surface coatings and efforts to prevent thromboembolism of the perfusion circuit.