title: Dramatic post-cardiotomy outcome, due to severe anaphylactic reaction to protamine.
abstract: Immunologic reactions to protamine sulfate during cardiac surgery are very rare. The frequency and outcome of such adverse reactions is unclear. We report a case of lethal anaphylactic reaction to protamine that occurred in a non-diabetic patient following the uneventful replacement of the ascending aorta. We also briefly review the mechanisms of this adverse reaction and emit some considerations on the management of this situation.
authors.affiliation: Clinic for cardio-vascular surgery, Department of Surgery, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. aristotepanos@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Panos
authors.forename: X
authors.initials: X
authors.lastname: Orrit
authors.forename: C
authors.initials: C
authors.lastname: Chevalley
authors.forename: A
authors.initials: A
authors.lastname: Kalangos
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D017809:Fatal Outcome; D006353:Heart-Assist Devices; D006494:Heparin Antagonists / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced*; D011479:Protamines / Q000009:adverse effects*
chemical_list: D006494:Heparin Antagonists; D011479:Protamines