The Journal of Thoracic and Cardiovascular Surgery, Vol 77, 277-282, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Use of athrombogenic tubing for perfusion rewarming following surface- induced deep hypothermia
H Mohri, T Ishitoya, EA Hessel 2d, G Schmer, DH Dillard and KA Merendino
A method of heparinless, oxygenatorless, left heart bypass perfusion
rewarming following surface hypothermia, with the use of a closed circuit
with 130 ml. prime volume including heat exchanger, has been devised. The
use of polyurethane-polyvinyl-graphite (PPG)-coated tubing has previously
been reported. In this text, the use of an athrombogenic coating with
cetyl-pyridinium chloride (CPC) as a regional heparin carrier was studied
in dogs, comparing groups with PPG tubing and total systemic heparinization
or plain polyvinyl tubing without systemic heparinization. Heparin
compounded in the CPC coating eluted into the blood and caused mild
transient whole-body heparinization during rewarming from 20 degrees to 25
degrees C., as evidenced by prolongation of the thrombin time. Alterations
of hematologic parameters in all three groups were similar to those during
surface rewarming except for those affected by heparinization. The left
heart bypass method was found useful for hypothermic open-heart surgery
when utilized with an athrombogenic surface coating or total body
heparinization. It was concluded that the CPC coating is superior to the
PPG coating since no cracking surface develops, it is translucent, and it
provides a more effective athrombogenic surface.