Clinical and biomaterial evaluation of hyaluronan-based heparin-bonded extracorporeal circuits with reduced versus full systemic anticoagulation in reoperation for coronary revascularization

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dc.contributor.authorGünaydın, Serdar
dc.contributor.authorFarsak, Bora
dc.contributor.authorMccusker, Kevin
dc.contributor.authorVijay, Venkataramana
dc.contributor.authorSarı, Tamer
dc.contributor.authorOnur, M. Ali
dc.contributor.authorZorlutuna, Yaman
dc.date.accessioned2020-06-25T17:48:40Z
dc.date.available2020-06-25T17:48:40Z
dc.date.issued2009
dc.departmentKırıkkale Üniversitesi
dc.descriptionONUR, MEHMET/0000-0002-3630-7982
dc.description.abstractObjective This prospective randomized study compares full and reduced heparinization on novel hyaluronan-based heparin-bonded circuits vs. uncoated controls under challenging clinical setting including biomaterial evaluation. Methods 100 patients undergoing reoperation for coronary artery bypass grafting were allocated into two equal groups (n = 50): Group one was treated with hyaluronan-based heparin bonded preconnected circuits (Vision HFOGBS, Gish, California, USA) and Group two with identical uncoated controls (Vision HFO, Gish, USA). In the study group, half of the patients (n = 25) received low-systemic heparin (125 IU/kg, ACT>250 s) or full dose like control group. Blood samples were collected after induction of anesthesia (T1) and heparin administration before cardiopulmonary bypass (CPB) (T2),15 min after initiation of CPB (T3), before cessation of CPB (T4),15 min after reversal with protamine (T5), and the first postoperative day at 08: 00 h (T6). Results Platelet counts were preserved significantly better at T5, T6 in hyaluronan groups (P<0.05 vs. control). Serum IL-2 levels were significantly lower at T4, T5 in both hyaluronan groups and C3a levels at T4 and T5 only in low-dose group (P<0.05). Troponin-T levels in coronary sinus blood demonstrated well preserved myocardium in hyaluronan groups. No significant differences in thrombin-antithrombin levels were observed between full and low-dose heparin groups at any time point. Amount of desorbed protein was 1.41 +/- 0.01 in full and 1.43 +/- 0.01 in low dose vs. 1.78 +/- 0.01 mg/dl in control (P<0.05). Conclusion Hyaluronan-based heparin-bonded circuits provided better clinical outcome and less inflammatory response compared with uncoated surfaces. Reduced systemic heparinization combined with hyaluronan-based heparin-bonded circuits is feasible and clinically well tolerated. J Cardiovasc Mad 10:135-142 (C) 2009 Italian Federation of Cardiology.en_US
dc.identifier.citationclosedAccessen_US
dc.identifier.doi10.2459/JCM.0b013e32831eef9d
dc.identifier.endpage142en_US
dc.identifier.issn1558-2027
dc.identifier.issue2en_US
dc.identifier.pmid19377380
dc.identifier.scopus2-s2.0-65549128732
dc.identifier.scopusqualityQ2
dc.identifier.startpage135en_US
dc.identifier.urihttps://doi.org/10.2459/JCM.0b013e32831eef9d
dc.identifier.urihttps://hdl.handle.net/20.500.12587/4524
dc.identifier.volume10en_US
dc.identifier.wosWOS:000263123700005
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofJournal Of Cardiovascular Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectbiocompatibleen_US
dc.subjectcardiopulmonary bypassen_US
dc.subjectcoated materialsen_US
dc.subjectcoronary artery bypassen_US
dc.subjecthyaluronanen_US
dc.subjectoxygenatoren_US
dc.titleClinical and biomaterial evaluation of hyaluronan-based heparin-bonded extracorporeal circuits with reduced versus full systemic anticoagulation in reoperation for coronary revascularizationen_US
dc.typeArticle

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