Abstract
Hypercholesterolemia is a well-known athero. genic factor. Endothelial damage increases the permeability for LDL, an atherogenic lipoprotein, The high permeability results in intimal accumulation of LDL which can trigger the development of atherosclerosis through the responses of macrophages and smnooth muscle cells, Therefore, we considered that it was very important to reduce serum LDL level as low as possible before LDL permeability is increased by drastic endothelial damage usually observed at the time of reperfusion in open heart surgery, and that this could prevent subsequent development of atherosclerosis in bypass grafts as well as native coronary arteries, In two patients, we performed LDL apheresis during cardiopulmonary bypass for coronary bypass surgery, LDL apheresis was carried out successfully without hemo-lysis Serum cholesterol and LDL levels were reduced to 1/3 and 1/4 or 1/5, respectively, The postoperative course was uneventful in the two patients, e consider that LDL apheresis during cardiopulmonary bypass is a useful method that can prevent subsequent development of athero-sclerosis in bypass grafts and native coronary arteries.
