[Does extracorporeal circulation during coronary artery bypass grafting damage vascular endothelium?].

The aim of the work was to study the influence of extracorporal circulation (ECC) on the vascular endothelial markers: von Willebrand factor (vWf), tissue plasminogen activator (t-PA) and trombomodulin (TM) in patients with coronary heart disease (CHD) undergoing coronary artery bypass graft (CABG). Examined group consisted of 30 patients (22 men, 8 women) at mean age 58.0 +/- 8.0 years, among them 19--were operated with ECC, 11--without ECC. Before and during operation blood was drawn 6 times. Control group consisted of 23. healthy volunteers at similar age. In the plasma vWf, t-PA and TM were determined with immunoenzymatic methods. Before operation the examined parameters were significantly higher compared to controls. The concentration of vWf during ECC was higher than in operation without ECC, but not significant. Differences statistically significant in the blood collected during ECC and without it appeared in t-PA only on the 3. and in TM on the 1. and 3. day after operation. It seems that ECC does not damage vascular endothelium direct, only indirect trough proinflammatory factors released from activated during ECC granulocytes and platelets.