Fibrinolysis system indicators during aorto-coronary bypass surgery in terms of cardiopulmonary bypass with minimized circuit

Abstract

Introduction. The problem of irregularities in the fibrinolysis system during extracorporeal circulation is investigated closely and does not lose its relevance. The aim of research. To research and identify fibrinolysis system violations performed in cardiac surgical patients undergoing cardiopulmonary bypass surgery with minimized extracorporeal circuit (MiECC). Materials and methods. 50 patients were examined with coronary artery bypass grafting: 15 ones operated with MiECC (main group); 35 ones operated with heparin-coated extracorporeal bypass circuits (control group). Performance evaluation of fibrinolytic system was carried out prior to surgery, after protamine, 12 hours after operation, 7 days later, on discharge and one month after surgery. Results. Balance of fibrinolytic system after the operation shifts to the side of the oppression. Structural parameters of a fibrin clot (size CS and D density) according to thrombodynamics test correlate well with Xll-dependent fibrinolysis. Patients after surgery with MiECC in comparison with the conventional circuit have lower thrombinemia, minimal number of activated platelets, faster recovery of plasma fibrinolytic capacity, and accordingly lower risks of thrombotic complications. Conclusion. Fibrinolysis system indicators show the advantage of usage at aorto-coronary bypass with minimized heparin-coated extracorporeal bypass circuits.