Prospective Randomized Comparisonof Miniaturized Extracorporeal Circulation System (Mecc) Versus Conventional Extracorporeal Circulation System (Cecc) In The Prevention Of Postoperative Atrial Fibrillation (Fa) And Other Clinical Results In Cardiac Surgery Patients

Introduction: Postoperative atrial fibrillation (AF) is the most common arrhythmia to occur after cardic surgery with an incidence between 20-45 %. It is associated with increased morbidity, including increased risk of stroke and need for additional treatment and costs. The pathophysiology of postoperative AF is not fully understood.cardiac surgery with extracorporeal circulation is known to be associated with a systemic inflammatory response,which may be in part responsible for postoperative AF. furthermore,foreign surface contact,blood-air contact,abnormal blood flow and hemodilution are broblems related to extracorporeal circulation. Hypothesis and Methods: In this prospective,randomized,open labelled clinical study,240 cardiac surgery patients were randomized either miniaturized extracorporeal circulation (MECC) group or conventional extracorporeal circulation (CECC) group before the surgery. The main outcome measure was the incidence of postoperative atrial fibrillation (AF) during the hospital stay after surgery. Other end points were use of blood products and vasoactive agents and the first (CKMBm) value postoperatively. Results: The incidence of postoperative atrial fibrillation was 43/120 (35.8 %) in the conventional extracorporeal circulation group (CECC) compared with 42/120 (35.0%) in the miniaturized extracorporeal circulation group (MECC) (p=0.893). The use of perioperative vasoactive agents was significantly lower in the (MECC) group compared with (CECC) group . Furthermore, the first postoperative CKMBm value was significantly lower in (MECC) patient group than in (CECC) patient group. There were no difference in the use of blood products between the groups. Conclusion: The clinical use of MECC with cardiac operative patients is safe and results are optimal when this procedure is performed by experienced teams. There were no difference in the incidence of postoperatrive atrial fibrillation (AF) between the groups, but the use of vasoactive agents was lower in (MECC) patient group, than in (CECC) patient group and also the first postoperative (CKMBm) value was lower in the (MECC) group than in (CECC) group.