1300 Participants Needed

MiECC vs Conventional Bypass for Heart Surgery

(MiECS Trial)

Recruiting at 12 trial locations
GP
Overseen ByGeorgios Papazisis, Assoc. Prof.
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Aristotle University Of Thessaloniki
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

MiECS is one of the largest multicentre randomised controlled trials on extracorporeal circulation conducted under the auspices of Minimal Invasive Extracorporeal Technologies International Society (MiECTiS). It is designed to ultimately address the emerging effectiveness of MiECC systems in the light of modern perfusion practice worldwide. The primary hypothesis is that MiECC, as compared to conventional CPB (cCPB), reduces the proportion of patients experiencing serious perfusion-related postoperative morbidity after cardiac surgery. The study will be led by the Clinical Research Unit of the Special Unit for Biomedical Research and Education (SUBRE), Aristotle University of Thessaloniki School of Medicine in Greece (AUSoM) with Chief Investigator Professor Kyriakos Anastasiadis, who is a key-opinion-leader in the field of MiECC, founder and Executive Board of MiECTiS.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is MiECC safe compared to conventional bypass for heart surgery?

Research shows that miniaturized extracorporeal circulation (MiECC) systems, compared to conventional cardiopulmonary bypass (CPB), may reduce some complications like inflammation and blood clotting issues, but they might also have less safety margin in certain situations. Overall, both systems have been tested in many studies, and while MiECC might offer some benefits, it's important to discuss individual risks with your doctor.12345

How does MiECC differ from conventional bypass in heart surgery?

MiECC (Minimal Invasive Extracorporeal Circulation) is a more advanced and less invasive form of heart-lung machine used during heart surgery, which aims to reduce the physical stress on the body compared to conventional cardiopulmonary bypass (CPB). This approach can potentially lead to fewer complications and a quicker recovery.678910

What data supports the effectiveness of the treatment MiECC compared to conventional bypass for heart surgery?

Research suggests that minimal extracorporeal circulation (MECC) and miniaturized cardiopulmonary bypass (Mini-CPB) can be equal or better alternatives to conventional cardiopulmonary bypass (C-CPB) in terms of reducing complications and the need for blood transfusions during coronary artery bypass surgery. These treatments may be particularly beneficial for high-risk patients or complex surgeries.111121314

Who Is on the Research Team?

KA

Kyriakos Anastasiadis, Professor

Principal Investigator

Aristotle University Of Thessaloniki

PA

Polychronis Antonitsis, Assoc. Prof.

Principal Investigator

Aristotle University Of Thessaloniki

Are You a Good Fit for This Trial?

This trial is for patients needing elective or urgent heart surgery for coronary artery disease or aortic valve issues, using a heart-lung machine but not requiring complex aortic surgery. Participants must be able to consent and can't have blood disorders or objections to blood transfusions.

Inclusion Criteria

I am scheduled for heart surgery involving bypass or valve replacement without stopping my circulation.

Exclusion Criteria

Inability to give informed consent for the study (e.g. learning or language difficulties)
You cannot or do not want to receive blood transfusions, for example, if you are a Jehovah's Witness.
I need major surgery on my aorta.
See 2 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo cardiac surgery using either MiECC or cCPB systems

1 week
In-hospital stay for surgery and initial recovery

Follow-up

Participants are monitored for postoperative complications and recovery

30 days
Regular follow-up visits and monitoring

Extended Follow-up

Participants' health-related quality of life is assessed

90 days

What Are the Treatments Tested in This Trial?

Interventions

  • Conventional cardiopulmonary bypass
  • Minimal Invasive Extracorporeal Circulation
Trial Overview The study compares two types of heart-lung machine techniques: the standard method (conventional cardiopulmonary bypass) and a newer, less invasive system (MiECC). The goal is to see if MiECC reduces serious complications after surgery.
How Is the Trial Designed?
2Treatment groups
Active Control
Group I: Minimal Invasive Extracorporeal Circulation (MiECC)Active Control1 Intervention
Patients undergoing coronary artery bypass grafting (CABG), aortic valve replacement (AVR), or combined procedure (AVR+CABG) with Minimal Invasive Extracorporeal Circulation (MiECC).
Group II: Conventional Cardiopulmonary Bypass (cCPB)Active Control1 Intervention
Patients undergoing coronary artery bypass grafting (CABG), aortic valve replacement (AVR), or combined procedure (AVR+CABG) with conventional cardiopulmonary bypass (cCPB)

Conventional cardiopulmonary bypass is already approved in European Union, United States, Canada, Japan, China, Switzerland for the following indications:

🇪🇺
Approved in European Union as cCPB for:
  • Cardiac surgery
  • Coronary artery bypass grafting (CABG)
  • Heart transplantation
  • Valve repair and replacement
🇺🇸
Approved in United States as cCPB for:
  • Cardiac surgery
  • Coronary artery bypass grafting (CABG)
  • Heart transplantation
  • Valve repair and replacement
🇨🇦
Approved in Canada as cCPB for:
  • Cardiac surgery
  • Coronary artery bypass grafting (CABG)
  • Heart transplantation
  • Valve repair and replacement
🇯🇵
Approved in Japan as cCPB for:
  • Cardiac surgery
  • Coronary artery bypass grafting (CABG)
  • Heart transplantation
  • Valve repair and replacement
🇨🇳
Approved in China as cCPB for:
  • Cardiac surgery
  • Coronary artery bypass grafting (CABG)
  • Heart transplantation
  • Valve repair and replacement
🇨🇭
Approved in Switzerland as cCPB for:
  • Cardiac surgery
  • Coronary artery bypass grafting (CABG)
  • Heart transplantation
  • Valve repair and replacement

Find a Clinic Near You

Who Is Running the Clinical Trial?

Aristotle University Of Thessaloniki

Lead Sponsor

Trials
283
Recruited
79,800+

Minimal Invasive Extracorporeal Technologies International Society (MiECTiS)

Collaborator

Trials
1
Recruited
1,300+

Clinical Research Unit, School of Medicine, Aristotle University of Thessaloniki

Collaborator

Trials
1
Recruited
1,300+

Published Research Related to This Trial

In a study of 236 high-risk patients undergoing coronary artery bypass graft surgery, miniaturized cardiopulmonary bypass (Mini-CPB) was associated with a significantly lower stroke rate (0%) compared to conventional cardiopulmonary bypass (C-CPB) which had a stroke rate of 5.4%.
While in-hospital mortality rates were similar between the two groups, Mini-CPB showed a trend towards better outcomes, suggesting that it may provide enhanced cerebral protection during surgery.
Miniaturized versus conventional cardiopulmonary bypass in high-risk patients undergoing coronary artery bypass surgery.Koivisto, SP., Wistbacka, JO., Rimpiläinen, R., et al.[2010]
In a study of 1472 coronary artery bypass grafting (CABG) operations, minimal extracorporeal circulation (MECC) showed lower rates of arrhythmia (25%) and neurocognitive disorders (3%) compared to conventional cardiopulmonary bypass (CCPB) which had 35.6% and 7% respectively, suggesting MECC may be safer for patients.
MECC also resulted in significantly fewer blood transfusions (0.8 per patient) compared to CCPB (1.8 per patient), indicating that MECC not only reduces perioperative complications but also minimizes the need for blood products, making it a preferable option for CABG surgery.
Minimal extracorporeal circulation and off-pump compared to conventional cardiopulmonary bypass in coronary surgery.Panday, GF., Fischer, S., Bauer, A., et al.[2009]
Miniaturised cardiopulmonary bypass (Mini-CPB) may lead to a lower risk of postoperative stroke (0.2% vs 2.0%) and somewhat reduced mortality (1.1% vs 2.2%) compared to conventional cardiopulmonary bypass (C-CPB), based on a meta-analysis of 13 studies involving 1161 patients.
Mini-CPB is associated with significantly less postoperative blood loss and a higher platelet count 6 hours after surgery, suggesting improved recovery outcomes, although further large-scale studies are needed for more definitive conclusions.
Meta-analysis of randomised trials comparing the effectiveness of miniaturised versus conventional cardiopulmonary bypass in adult cardiac surgery.Biancari, F., Rimpiläinen, R.[2009]

Citations

Miniaturized versus conventional cardiopulmonary bypass in high-risk patients undergoing coronary artery bypass surgery. [2010]
Minimal extracorporeal circulation and off-pump compared to conventional cardiopulmonary bypass in coronary surgery. [2009]
Meta-analysis of randomised trials comparing the effectiveness of miniaturised versus conventional cardiopulmonary bypass in adult cardiac surgery. [2009]
Beneficial effects of using a minimal extracorporeal circulation system during coronary artery bypass grafting. [2014]
Outcome after coronary artery bypass surgery with miniaturized versus conventional cardiopulmonary bypass. [2009]
Safety and efficacy of miniaturized extracorporeal circulation when compared with off-pump and conventional coronary artery bypass grafting: evidence synthesis from a comprehensive Bayesian-framework network meta-analysis of 134 randomized controlled trials involving 22 778 patients. [2022]
Comparison of minimally invasive closed circuit extracorporeal circulation with conventional cardiopulmonary bypass and with off-pump technique in CABG patients: selected parameters of coagulation and inflammatory system. [2006]
Initial experience with a minimized extracorporeal bypass system: is there a clinical benefit? [2006]
Miniaturized cardiopulmonary bypass in coronary artery bypass surgery: marginal impact on inflammation and coagulation but loss of safety margins. [2006]
Oncoplastic versus conventional breast-conserving surgery in breast cancer: a pooled analysis of 6941 female patients. [2023]
Comparing costs of standard Breast-Conserving Surgery to Oncoplastic Breast-Conserving Surgery and Mastectomy with Immediate two-stage Implant-Based Breast Reconstruction. [2022]
Beating heart against cardioplegic arrest studies (BHACAS 1 and 2): quality of life at mid-term follow-up in two randomised controlled trials. [2015]
Comparison of Oncoplastic Breast Surgery, Non-oncoplastic Breast Conserving Surgery and Mastectomy in Early Breast Cancer: A Single Center Retrospective Study. [2021]
14.United Statespubmed.ncbi.nlm.nih.gov
Technical feasibility and cosmetic advantage of hybrid endoscopy-assisted breast-conserving surgery for breast cancer patients. [2013]
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