Minimal Invasive Extra-corporeal Circulation on End Stage Coronary Artery Disease Patients Undergoing Myocardial Revascularization

Background: Patients with coronary artery disease (CAD) undergoing myocardial revascularization, with concomitant heart failure defined by left ventricular ejection fraction (LVEF) lower than 35%, constitute a population at risk of poor long-term prognosis and limited survival. The benefits of minimal invasive extracorporeal circulation (MiECC) on end stage coronary artery disease patients undergoing myocardial revascularization has not been described and evidenced by scientific studies. Materials and Methods: In this single-centre control study of 60 end stage coronary artery disease patients undergoing isolated coronary artery bypass grafting.The patients was divided in two contemporary groups: in group (MiECC), n= 30 coronary artery bypass grafting (CABG) was used MiECC, whereas, in group conventional extracorporeal circulation (cECC), n=30 CABG was used cECC. Results: Procedures of Group MiECC reported (mean values) of a DO 2i of 305 mL/min/m 2 in relation to O 2 ER i 21.5% vs a DO 2i of 288 mL/min/m 2 in relation to O 2 ER i 25.6% was found in group MiECC vs cECC (p=0.037). Lactate levels >3 mmol/L were reported in 7 group MiECC patients vs 20 group cECC patients (p=0.038), with blood glucose peak. Mean nadir Hb values during CPB were 9.7 g/dL in group MiECC vs 7.8 g/dL in group cECC (p = 0.044). CI during CPB was 2.4 L/min/m 2 in both groups. Total red blood cell administration was 8 units in group MiECC vs 21 units in group cECC (p=0.022). A glycemic peak was recorded in 7 patients of group MiECC vs 20 patients of group cECC (p=0.037). Conclusion: The MiECC technique on end stage coronary artery disease was associated with a higher DO 2i compared to cECC. MiECC patients showed a significant reduction in red blood cells units administration, in peak intraoperative lactate levels, which correlated with better postoperative renal outcome and shorter length of stay.