Document Detail


Aortic valve replacement with the minimal extracorporeal circulation (Jostra MECC System) versus standard cardiopulmonary bypass: a randomized prospective trial.
MedLine Citation:
PMID:  15354105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We prospectively evaluated a newly introduced minimal extracorporeal circulation system (Jostra MECC System; Jostra AG, Hirrlingen, Germany) for aortic valve surgery. METHOD: In a prospective, randomized study, 100 patients underwent aortic valve replacement either with standard cardiopulmonary bypass (n = 50, group B) or with the MECC System (n = 50, group B). The myocardial protection and the left vent were identical for the two groups. The intrapericardial suction device was never used (only the cell salvage device was used) to reduce the air-blood contact area. RESULTS: No significant differences were noted in patient characteristics and operative data between groups. Operative mortality (<30 days) was 2% for group A and 4% for group B (difference not significant). From the preoperative period to the postoperative period, the increase in C-reactive protein was significantly higher for group B (P <.001). The postoperative troponin I level was significantly lower in group A (mean 4.65 +/- 2.9 microg/L at 24 hours) than in group B (8.2 +/- 4.4 microg/L, P <.03). On the other hand, the MECC System was associated with platelet preservation. Renal function was better preserved and the neurologic event rate was significantly lower for the MECC group (P <.02). CONCLUSION: The MECC System is safe and allows aortic valve replacement under the most favorable conditions. The system is more biocompatible than standard cardiopulmonary bypass and provides a good postoperative biologic profile and good clinical results, particularly for high-risk patients.
Authors:
J P Remadi; Z Rakotoarivello; P Marticho; F Trojette; A Benamar; H Poulain; C Tribouilloy
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  128     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-08     Completed Date:  2004-10-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  436-41     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Surgery Unit and Anaesthesiology Department, South Hospital, Amiens, France. remadi.jean-paul@chu-amiens.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve / surgery*
Cardiopulmonary Bypass
Equipment Design
Extracorporeal Circulation / instrumentation*
Female
Humans
Male
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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