This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Tomas Vanek Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Vanek, T. Articles by Maly, M. Search for Related Content PubMed PubMed Citation Articles by Vanek, T. Articles by Maly, M. Related Collections Cardiac - other Extracorporeal circulation Minimally invasive surgery

Fibrinolysis in coronary artery surgery: detection by thromboelastography

^a Department of Cardiac Surgery, 3rd Faculty of Medicine, Charles University Prague and University Hospital Kralovske Vinohrady, Czech Republic
^b Department of Biostatistics and Informatics, National Institute of Public Health, Prague, Czech Republic

*Corresponding author. Department of Cardiac Surgery, FNKV, Srobarova 50, 100 34 Prague 10, Czech Republic. Tel.: +420 267 163 422; fax: +420 267 163 260.

E-mail address: vanek{at}fnkv.cz (T. Vanek).

Sixty-five patients scheduled for coronary surgery were randomized into three groups: A – conventional coronary artery bypass grafting, B – off-pump surgery, C – coronary artery bypass grafting with modified, rheoparin coated cardiopulmonary bypass with the avoidance of re-infusion of cardiotomy blood into the circuit. On the completion of peripheral bypass anastomoses, highly significant inter-group differences were found in the thromboelastographic parameter lysis of set time at 60 min of assessment (P=0.003) and at 150 min of assessment (P<0.001), the mean values of these parameters were significantly lower in group A as compared with both groups B and C, which were statistically indistinguishable. Lysis on set time on the completion of peripheral bypass anastomoses <50% was detected in 12 patients (52.2%) originating from group A. At the other sampling times (preoperatively, 15 min after sternotomy, at the end of the procedures, and 24 h later) thromboelastographic parameters were similar in all groups. In group A no significant correlations between lysis on set time, postoperative blood loss and D-dimer levels were found. Based on our results, thromboelastographic signs of fibrinolysis were clearly detectable during cardiopulmonary bypass in group A, but not at any time in groups B and C.

Key Words: Coronary artery surgery; Beating heart surgery; Cardiopulmonary bypass; Hemostasis; Thromboelastography; D-dimer