[Left heart bypass with the bio-medicus centrifugal pump by the use of an antithrombin agent, argatroban].
Seventeen adult patients who underwent surgery for the thoracic or thoracoabdominal aortic disease by the use of left heart bypass with the Bio-Pump were divided into untreated, low-dose heparin treated and argatroban treated groups so as to evaluate the effects of systemic infusion of a newly synthesized antithrombin agent, argatroban, for the prevention of platelet loss and consumption coagulopathy. ACT reached 150 to 250 seconds at doses 0.5-7.5 micrograms/kg/min of argatroban and maximum ACT prolongation was limited to around 250 seconds. ACT spontaneously recovered below 150 seconds within 60 minutes following the end of bypass during which no excessive blood loss developed. In argartoban group, platelet loss during and immediately after surgery was effectively prevented as compared to other groups with significance. Fibrinogen was also preserved to some extent by argatroban treatment without evidence of systemic embolization. Argatroban, as an antithrombotic agent, is worthy of further trial of clinical use in bypass with a centrifugal pump.
Kawada
T
T
Third Department of Surgery, St. Marianna University Hospital, Kawasaki, Japan.
Mieda
T
T
Abe
H
H
Kamata
S
S
Nakamura
S
S
Endo
S
S
Kikuchi
K
K
Miyamoto
S
S
Nishimura
K
K
Funaki
S
S
D000328:Adult; D000368:Aged; D000991:Antithrombins / Q000008:administration & dosage*; D001018:Aortic Diseases / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D001120:Arginine / Q000031:analogs & derivatives; D002498:Centrifugation / Q000295:instrumentation*; D018611:Heart Bypass, Left / Q000379:methods*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008875:Middle Aged; D010875:Pipecolic Acids / Q000008:administration & dosage*; D010976:Platelet Count; D013449:Sulfonamides; D014914:Whole Blood Coagulation Time
D000991:Antithrombins; D010875:Pipecolic Acids; D013449:Sulfonamides; D001120:Arginine; C031942:argatroban