NCT03622671

Fibrin Clot Properties and Blood Loss Following Coronary Artery By-pass Grafting

Association of Fibrin Clot Properties With Blood Loss Following Coronary Artery By-pass Grafting - Does Surgical Technique of Left Internal Mammary Artery Harvesting Matter

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 62 (actual)
• Sponsor: Jagiellonian University · Academic / Other
• Sex: All
• Age: 18 Years – 80 Years
• Healthy volunteers: Not accepted

Summary

Up to 15% of operations in cardio-pulmonary by-pass are complicated by excessive postoperative blood loss, which negatively affects the outcomes. Recently, it has been demonstrated that fibrin clot susceptibility to lysis is a modulator of postoperative blood loss after cardiac surgery for aortic stenosis. Earlier, a preliminary study showed a negative association of postoperative blood loss after coronary artery by-pass grafting (CABG) with fibrin clot lysis time, reflecting susceptibility to fibrinolysis. In CABG, postoperative blood loss may depend on the operative technique with respect to left internal mammary artery (LIMA) harvesting. LIMA is taken down in virtually all CABG procedures, but harvesting technical details remain at surgeons discretion (skeletonization without opening the pleural cavity vs. pedicled graft with pleura wide open). The investigators decided to test the hypothesis that fibrin clot properties modulate the postoperative drainage following CABG strongly enough to attenuate the influence of surgical technique by randomizing the patients undergoing CABG with regard to LIMA harvesting technique.

Conditions

• Coronary Artery Disease
• Internal Mammary-Coronary Artery Anastomosis
• Coronary Artery Bypass
• Blood Loss, Postoperative
• Fibrinolysis

Interventions

Type	Name	Description
PROCEDURE	Skeletonized LIMA	Standard CABG - no different form any other procedure of this type except LIMA will be skeletonized without opening the pleura
PROCEDURE	Pedicled LIMA	Standard CABG - no different form any other procedure of this type except LIMA will be taken down as a pedicled graft with opening the pleura

Timeline

• Start date: 2018-09-26
• Primary completion: 2019-12-24
• Completion: 2020-02-10
• First posted: 2018-08-09
• Last updated: 2020-02-12

Locations

1 site across 1 country: Poland