Undergoing cardiopulmonary bypass using enoxaparin only during a cardiac transplantation procedure.
The use of enoxaparin as a replacement drug to standard heparin, for anticoagulation during extracorporeal circulation, in patients with heparin-induced thrombocytopenia, is still very limited. Enoxaparin significantly reduces thrombin formation and activity during cardiopulmonary bypass. The prolonged circulating rate, slow elimination rate and non-total reversion of enoxaparin by protamine can induce important postoperative bleeding. We are describing the first case of cardiac transplantation where enoxaparin was used as a replacement drug to standard heparin.
Prifti
E
E
Istituto di Chirurgia Toracica, Cardiovascolare e Technologie Biomediche, Università degli Studi di Siena, Siena, Italy. edvinprifti@hotmail.com
Bonacchi
M
M
Leacche
M
M
Miraldi
F
F
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006328:Cardiac Catheterization; D002315:Cardiopulmonary Bypass; D004452:Echocardiography; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000601:surgery; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D018570:Risk Assessment; D013923:Thromboembolism / Q000517:prevention & control
D000925:Anticoagulants; D017984:Enoxaparin