Journal of Coronary Artery Disease
Online ISSN : 2434-2173
Original Articles
Modified Extracorporeal Membrane Oxygenation Offers Stable Hemodynamic Conditions with Less Invasiveness in Coronary Artery Bypass Grafting
Koji Hirano Toshiya TokuiBun NakamuraRyosai InoueReina HiranoYasumi MazeHiromu KitamuraHisato ItoYu ShomuraMotoshi Takao
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2020 Volume 26 Issue 2 Pages 29-39

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Abstract
Objective: Cardiopulmonary bypass offers a stable hemodynamic condition during coronary bypass surgery, but undesirable side-effects emerge as complicating issues. We developed a minimally invasive cardiopulmonary bypass modifying extracorporeal membrane oxygenation to alleviate the side-effects of conventional cardiopulmonary bypass. Herein, we evaluated the effectiveness of the modified extracorporeal membrane oxygenation in coronary bypass surgery. Materials and methods: 79 patients who underwent coronary bypass surgery using cardiopulmonary bypass between January 2014 and March 2019 were divided into those using conventional cardiopulmonary bypass (n=47) and those using the modified extracorporeal membrane oxygenation (n=32). We compared the results of these groups. Results: The operation time in the patients with the modified extracorporeal membrane oxygenation were significantly shorter than those with conventional cardiopulmonary bypass (p =0.001). Heparin and priming volume were less required for the modified extracorporeal membrane oxygenation. The in-hospital mortality and morbidity were comparable between the groups. However, the length of intubation and intensive care unit stay following the operation with the modified extracorporeal membrane oxygenation were significantly shorter than those with conventional cardiopulmonary bypass (p =0.018 and p =0.001, respectively). Furthermore, the creatinine kinase MB isozyme value at the end of the operation with the modified extracorporeal membrane oxygenation was significantly lower than that with conventional cardiopulmonary bypass (p =0.002). Conclusion: Our modified extracorporeal membrane oxygenation seemed less invasive than conventional cardiopulmonary bypass because of the reduced operation time and the early postoperative recovery. This system is beneficial when performing coronary bypass surgery, especially for high-risk patients.
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© 2020 The Japanese Coronary Association
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