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The thrombus formation during extracorporeal circulation (ECC) and the effectiveness of the pretreatment with antiplatelet drugs were investigated.Forty-three patients who underwent valvular surgery were divided into four groups: Group A; control, Group B; dipyridamole 300mg/day, Group C; ticlopidine 300mg/day, Group D; ticlopidine 600mg/day, each drug was administered orally for seven days continuously before operation. Using the electron microscopy, we observed the inner surfaces of the bubble oxygenator after surgery, and evaluate the extent of the deposits of thrombi on those surfaces. And also the platelet-microaggregates were examined by evaluating the size-distribution of the platelets of the circulating blood. Results: In group A, all samples of the surfaces of the oxygenators were covered in layers with huge thrombi or platelet aggregates. On the contrary in groups B, C, and D, almost all surfaces of the oxygenators were kept bare with few adhesion of thrombi or platelet-microaggregates. As for platelets size-distribution, in group A, both used or consumed platelets, namely, small size platelets (1-4m3) and the platelet aggregates (25μm3<) increased along the duration of the time of the ECC. Meanwhile in group C and D, both small size and extremely large size platelet aggregates were kept in steady level and did not show any increase during ECC. It means that the pretreatment with antiplatelet drugs is an useful and effective method to prevent the thrombus formation during ECC. And also no increase in the postoperative blood loss or no bleeding tendency after operation were induced by the pretreatment with antiplatelet drugs.

Thrombus formation on the surfaces of the oxygenator during extracorporeal circulation