Argatroban as a substitute of heparin during cardiopulmonary bypass: A safe alternative?

Fabrizio Follis, Gianfranco Filippone, Giuseppe Montalbano, Maria Floriano, Ettore LoBianco, Giuseppe D'Ancona, Marco Follis

Research output: Contribution to journalArticle

Abstract

Objective: The patient with a diagnosis of heparin-induced thrombocytopenia and thrombosis who requires urgent cardiac surgery represents a formidable challenge. Among the alternatives to heparin, argatroban has gained widespread use in non-cardiac surgery patients. The object of this communication is to report our recent experience with this agent during cardiopulmonary bypass (CPB) and to review the cases previously published in order to better define indications, dosage, monitoring and limitations in cardiac surgery patients. Methods: A case of mitral valve replacement where argatroban was used for anticoagulation during CPB is described. The literature on the subject is reviewed and the relationship between argatroban dosage and activated clotting time (ACT) is studied by regression analysis. Results: Clotting of the oxygenator requiring prompt replacement occurred after release of cross-clamp. Upon termination of the drug, ACT remained elevated beyond the expected half-life. A significative (P

Original languageEnglish
Pages (from-to)592-596
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume10
Issue number4
DOIs
Publication statusPublished - Apr 2010

Keywords

  • Blood coagulation/anticoagulation
  • Cardiopulmonary bypass
  • Physiology/pathophysiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

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