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Leukocyte filtration in the early reperfusion phase on cardiopulmonary bypass reduces myocardial injury

Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt, matheis.gbr{at}gmx.de

M Scholz

Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt

J Gerber

Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt

U Abdel-Rahman

Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt

G Wimmer-Greinecker

Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt

A Moritz

Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt

Improved myocardial protection and cardiopulmonary bypass (CPB) have limited, but not abolished, intraoperative myocardial damage due to surgical reperfusion injury after release of the aortic crossclamp. In this double-blind, randomized study, we evaluated whether short-term leukocyte filtration during reperfusion may further reduce myocardial damage. Thirty-eight patients with coronary artery disease were randomly assigned to CPB with (group I; n = 19) or without leukocyte filtration (group II; n = 19). There was no difference in bypass time or crossclamp time between the groups. No patient in group I required catecholamines, whereas three patients in group II were supported with adrenaline or dobutamine on the first and second postoperative day. In addition, troponin T plasma levels were lower in group I (p < 0.05), whereas other markers for tissue injury (CK, CK-MB, LDH, SGOT and S100B) did not differ. In conclusion, leukocyte filtration during reperfusion may further improve CPB by reducing myocardial damage.

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