Cardiopulmonary bypass technologies - Biomaterials and Devices for the Circulatory System - page 145

Table 6.2 Surface coatings available in the market

Surface coating Trade name and manufacturer

Polymer
Polymethoxyethylacrylate (X coating, Terumo, Somerset, NJ, USA)

Phosphorylcholine (Phisio, Dideco, Mirandola, Italy)

Polypeptide (Safeline, Maquet, Hirrlingen, Germany)

Hyaluronan (GBS-HF, Gish Biomedical, CA, USA)

Polymer-based heparin coated
Polyethylene oxide (Trillium, Medtronic, Minneapolis, MN, USA)

Polypeptide (Bioline, Maquet, Hirrlingen, Germany)

Hyaluronan (GBS, Gish Biomedical, CA, USA)

Rheoparine (Medos, Stolberg, Germany)

the early 1980s, several manufacturers of cardiovascular equipment explored
the feasibility of incorporating heparin coating into commonly used perfu-
sion supplies. This exploration resulted in the development of the two most
common and most researched commercial heparin coatings: Durafl o II
(Edwards Life Sciences, Irvine, CA, USA) and Carmeda Bioactive Surfaces
(Medtronic, Inc, Minneapolis, MN, USA). All of the major manufacturers
of cardiovascular perfusion equipment have either developed or are in the
process of developing modifi cations of circuitry for CPB for the last ten
years (Table 6.2).
First generation heparin-coated circuits improved biocompatibility to
some extent but they were still imperfect. They did not decrease the infl am-
matory response to CPB and thrombogenesis was not reduced. Also sys-
temic heparinization should be maintained to avoid complications second-
ary to the activation of coagulation. 11 Possible complications of circulating
heparin, especially heparin-induced thrombocytopenia, and adverse effects
of porcine heparin reported have made heparin coating controversial and
less preferable. 12
Polymer-coated circuits were then commercialized. Polymethoxyethylac-
rylate, polypeptide, and phosphorylcholine were the most popular materi-
als. 13 Polymer

￿ ￿ ￿ ￿ ￿

heparin-coated circuits have followed. Biopassive surface
and hyaluronan were pioneering ones in the market. 14
Gunaydin et al. initially started research on clinical effi cacy of surface
coating in cardiac surgery in 2002. Sixty patients undergoing three-vessel
coronary artery bypass grafting were divided into two equal groups of
polymethoxyethylacrylate coated circuits and uncoated control. 15 Haemo-
dynamic variables, blood and urine test results, hematologic variables, com-
plement fractions, C3a and C4d, and interleukin-6 levels were documented.
Protein electrophoresis was performed. Blood cell adhesion and aggrega-

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