Off-Pump Versus On-Pump Coronary Artery Surgery Identification of Fibrinolysis Using Rotation Thromboelastography; A Preliminary, Prospective, Randomized Study:Identification of Fibrinolysis Using Rotation Thromboelastography; A Preliminary, Prospective

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概要

• 論文の詳細を見る

• The aim of this preliminary, prospective, randomized study was to compare rotation thromboelastography (roTEG) results and D-dimer levels in off-pump versus on-pump coronary surgery in order to identify the activation of fibrinolysis. Twenty patients scheduled for coronary bypass grafting were assessed (off-pump group A, n = 10; on-pump group B, n = 10). Blood samples for roTEG examination were taken preoperatively (t0), 15 minutes after sternotomy (t1), on the completion of peripheral bypass anastomoses (t2), and at the end of procedures (t3). The time points for D-dimer levels analyses were before operation, at the end of procedures, and 24 hours later. A certain degree of roTEG signs of fibrinolysis was noticed at time t2 in both groups and in group B these marks were quite widely, but not significantly expressed (P for intergroup differences for Lysis on Set Time at 60 and 150 minutes were P = 0.190 and P = 0.122, respectively), borderline differences were found for Maximum Clot Firmness (P = 0.082) with a lower mean value for group B (arithmetic means [95% confidence intervals] - 57.7 [54.2; 61.2] mm). Completely expressed roTEG signs of hyperfibrinolysis were observed in 2 patients from group B. In group B also the highest geometric means of D-dimers (1326.0 [943.5; 1863.6] ng mL-1) and thus a dramatic intergroup difference (P < 0.001) were observed at the end of surgery; 24 hours later the significantly elevated D-dimer levels in both groups (A: 1070.0 [723.5; 1582.6] versus B: 1093.3 [732.0; 1632.9] ng mL-1) were equalized (P = 0.932). Our roTEG results display a slightly greater, but fairly subtle activation of fibrinolysis during the course of cardiopulmonary bypass, compared to off-pump cardiac surgery.

• International Heart Journal刊行会の論文

著者

• Snircova Jana

  Department of Cardiac Surgery, Third Faculty of Medicine, Charles University in Prague, Kralovske Vinohrady University Hospital

• Jares Martin

  Department of Cardiac Surgery, Third Faculty of Medicine, Charles University in Prague, Kralovske Vinohrady University Hospital

• Vanek Tomas

  Department of Cardiac Surgery, Third Faculty of Medicine, Charles University in Prague, Kralovske Vinohrady University Hospital

• Bednar Frantisek

  Department of Cardiac Surgery, Third Faculty of Medicine, Charles University in Prague, Kralovske Vinohrady University Hospital

• Maly Marek

  Department of Biostatistics and Informatics, National Institute of Public Health

• Straka Zbynek

  Department of Cardiac Surgery, Third Faculty of Medicine, Charles University in Prague, Kralovske Vinohrady University Hospital

関連論文

• Off-Pump Versus On-Pump Coronary Artery Surgery Identification of Fibrinolysis Using Rotation Thromboelastography; A Preliminary, Prospective, Randomized Study:Identification of Fibrinolysis Using Rotation Thromboelastography; A Preliminary, Prospective
• Postoperative Blood Loss in Coronary Surgery No Real Impact of Fibrinolysis Detected by Thromboelastography and D-Dimers. A Prospective, Randomized Study:No Real Impact of Fibrinolysis Detected by Thromboelastography and D-Dimers. A Prospective, Randomiz
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