THE PROTECTIVE BENEFITS OF MINIMAL INVASIVE EXTRACORPOREAL CIRCULATION IN CORONARY ARTERY BYPASS SURGERY: A SINGLE-CENTER EXPERIENCE

Background and Aim: Minimal invasive extracorporeal circulation (MiECC) is an advanced CPB technology that reduces complications compared to standard CPB. The study aims to evaluate the effectiveness of MiECC in coronary artery bypass (CABG) surgery, focusing on outcomes like inflammation, blood transfusion and organ protection. Methods: From April 2016 to June 2024, 63 patients underwent CABG procedure with MiECC at our center. A 1:1 propensity-matching algorithm was employed to match the patients with 63 patients who underwent CABG procedure with standard ECC. The variables used for matching were age, sex, BMI, LVEF, presence of diabetes mellitus, renal insufficiency, cross-clamp time and number of distal anastomosis. Results: Intra-operative outcomes demonstrated lower levels of lactates and glycemia in MiECC group with a statistical significance (2.1±0.8 vs 1.4±0.7, p<0.001 and 164±35.8 vs 124.4±31.5, p<0.001, respectively). Early postoperative outcomes were similar between MiECC and standard ECC groups regarding renal and liver impairment and bleeding. LDH values were statistically inferior in MiECC group (419.9±239.8 vs 210.6±42.1, p<0.001). Needing of inotropes over 24-hours and MOF were higher in standard ECC group, without a statistical significance. 30-day mortality was higher in standard ECC group (3 vs 0, p=0.08). Conclusions: The use of MiECC for CABG surgery in our analysis showed a significant lower alteration in metabolic parameters such as lactate and blood glucose levels, suggesting a better overall patients’ perfusion during the procedure. Clinically, this translates in a shorter intubation time anf reduced ICU stay for the MiECC group.