Cardiopulmonary bypass using nafamostat mesilate for patients with infective endocarditis and recent intracranial hemorrhage.
Infective endocarditis is a life threatening disease with high mortality and morbidity, including brain infarction concomitant with intracranial hemorrhage. Generally, patients with a recent intracranial hemorrhage are believed to be a contraindication to undergo cardiac surgery with cardiopulmonary bypass. However, some patients with infective endocarditis occasionally require an unavoidable emergent surgery because of uncontrollable heart failure or on-going thromboembolism even if complicated by intracranial hemorrhage. In this study, a cardiopulmonary bypass strategy using nafamostat mesilate as an anticoagulant for such patients is discussed based on three cases we experienced.
Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Takeyoshi
T
Ota
Kenji
K
Okada
Hiroya
H
Kano
Yutaka
Y
Okita
D000328:Adult; D000368:Aged; D001550:Benzamidines; D002315:Cardiopulmonary Bypass; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000601:surgery*; D005260:Female; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D011480:Protease Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D001550:Benzamidines; D006146:Guanidines; D011480:Protease Inhibitors; C032855:nafamostat