• John C Mullen, Michael J Bentley, Elliot T Gelfand, Arvind Koshal, Dennis L Modry, Craig R Guenther, Wai S Etches, Linda J Stang, and Steven R Lopushinsky.
• Division of Cardiac Surgery, The University of Alberta, Edmonton. jmullen@ualberta.ca
• Can J Surg. 2002 Jun 1; 45 (3): 166-72.

ObjectiveTo evaluate the safety and efficacy of heparin-coated perfusion circuits with low-dose heparinization and centrifugal pumping compared with the standard method during coronary artery bypass grafting.DesignProspective, randomized, single-blind clinical trial.SettingA primary care institution.PatientsNinety patients who underwent first-time elective coronary artery bypass grafting were eligible for the study. After giving informed consent, they were randomly assigned to 1 of 3 groups (30/group).InterventionsPerfusion on regular uncoated bypass equipment with a roller pump and full-dose heparinization (300 IU/kg bolus, activated clotting time [ACT] > 400 s) (group 1), on a heparin-coated oxygenator with a centrifugal pump and full-dose heparinization (group 2) and on fully heparin-coated bypass equipment with a centrifugal pump and low-dose heparinization (100 IU/kg bolus, ACT of 180-400 s) (group 3). Standard coronary artery bypass grafting was performed.Outcome MeasuresPostoperative bleeding, transfusion requirements and clinical outcomes.ResultsThere were no complications related to the study protocol. Study groups were similar in terms of postoperative bleeding, transfusion requirements and clinical outcomes.ConclusionsHeparin-coated cardiopulmonary bypass with low-dose heparinization and centrifugal pumping is a safe practice but showed no advantages over the use of regular uncoated bypass circuits for coronary bypass surgery.

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