Department of Cardiac Surgery, Artemed Klinikum München Süd, 81379 Munich, Germany.
Department of Cardiac Surgery, Paracelsus Medical University, 40791 Nuremberg, Germany.
Medicina (Kaunas). 2022 Oct 10;58(10):1427. doi: 10.3390/medicina58101427.
: The hemoadsorption device CytoSorb (CytoSorbents Inc., Princeton, NJ, USA) has been shown to efficiently remove ticagrelor from whole blood in vitro. A promising clinical experience was made with the integration of the hemoadsorption cartridge on the cardiopulmonary bypass (CPB) circuit during cardiac surgery to reduce adverse events. : In this report, we describe a novel approach using a new apheresis platform, PUR-01 (Nikkisio Co., Ltd., Tokyo, Japan), which was used as the extracorporeal circuit where CytoSorb could be installed for the removal of ticagrelor during off-pump coronary artery bypass (OPCAB) procedures. : In a 74-year-old male (index case) with coronary artery disease and dual antiplatelet therapy, hemoadsorption was initiated with a skin incision for OPCAB surgery and was continued for 221 min to eliminate ticagrelor. The blood volume that had circulated through the CytoSorb was 39.04 L in total. Thus far, this treatment strategy has been used in four cases with CHD and DAPT who needed OPCAB surgery. The intraoperative and postoperative courses were uneventful in all patients. No device-related adverse events occurred. : The combination of the PUR-01 apheresis pump and hemoadsorption with the CytoSorb column during OPCAB procedures appears to be safe and effective in eliminating antiplatelet drugs.
: 体外研究表明，血液吸附装置 CytoSorb（CytoSorbents Inc.，新泽西州普林斯顿）能够有效清除全血中的替格瑞洛。在心脏手术中，将血液吸附柱整合到体外循环（CPB）回路中以减少不良事件，这一临床应用经验令人充满希望。: 在本报告中，我们描述了一种新的方法，使用新型血浆分离平台 PUR-01（日本日机装株式会社）作为体外回路，可在非体外循环冠状动脉旁路移植术（OPCAB）期间安装 CytoSorb 以清除替格瑞洛。: 在一位 74 岁男性（首发病例）冠心病合并双联抗血小板治疗患者中，在切开皮肤进行 OPCAB 手术时开始进行血液吸附，持续 221 分钟以清除替格瑞洛。总共循环通过 CytoSorb 的血液量为 39.04 L。迄今为止，该治疗策略已用于 4 例需要 OPCAB 手术的 CHD 和 DAPT 患者。所有患者的术中及术后过程均顺利，无与器械相关的不良事件发生。: 在 OPCAB 手术期间，将 PUR-01 血浆分离泵与 CytoSorb 柱结合进行血液吸附，似乎在消除抗血小板药物方面是安全且有效的。
