The Effect of Hemoperfusion on Bleeding after CABG in Patients on Preoperative Plavix: A Pilot Study

Alireza  Jahangirifard; Mandana Hossein  Zadeh; Seyed Bashir  Mirtajani; Hamid Jamali  Taraei; Farzad  Salari; Mohammad Hossein  Mandegar

doi:10.18502/aacc.v10is1.17197

Alireza Jahangirifard Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mandana Hossein Zadeh Masih Deveshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Seyed Bashir Mirtajani Lung transplant Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hamid Jamali Taraei Bank Melli Hospital, Tehran, Iran.
Farzad Salari Bank Melli Hospital, Tehran, Iran.
Mohammad Hossein Mandegar Department of Cardiac Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10is1.17197

Keywords: CABG; Hemoperfusion; Plavix; Postoperative bleeding

Abstract

Background: Bleeding management during and after urgent heart surgery is always challenging in patients who are taken anticoagulants especially antiplatelet ones. The present study was conducted with the aim of investigating the role of intraoperative hemoperfusion in the active removal of Plavix in patients undergoing on-pump CABG surgery.

Methods: The present study recruited patients on Plavix who underwent urgent CABG surgery. All patients have discontinued consuming Plavix less than 36 hours before surgery. During cardiopulmonary bypass, hemoperfusion set was added to the circuit and the surgery was done according to the standard open heart surgery protocols. The patients were transferred to the intensive care unit at the end of surgery and amount of bleeding was recorded in the ICU sheet hourly and calculated after 24 hours.

Results: In our study, the average age of participating patients was 73,625 years. 5 patients out of 8 (62.5%) were male and 3 (37.5%) were female. Hypertension and blood type O were the most prevalent among the patients. The average amount of bleeding was 425 in the first day after surgery and the average units of transfused blood for patients was 0.125, which is acceptable and less than the values reported in other studies that do not use the hemoperfusion.

Conclusion: The use of hemoperfusion during urgent CABG surgery, can reduce the postoperative bleeding and blood products consumption in patients on preoperative Plavix.