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Thorac Cardiovasc Surg 1998; 46(5): 303-304
DOI: 10.1055/s-2007-1010243
Case Report

© Georg Thieme Verlag Stuttgart · New York

Heparin Removal after Cardiopulmonary Bypass in a Patient with Adverse Reaction to Protamine

H. T. Tevaearai, D. Jegger, X. M. Mueller, J. Horisberger, L. K. von Segesser
  • Department of Cardiovascular Surgery, University Hospital, Lausanne, Switzerland
Further Information

Publication History

1998

Publication Date:
19 March 2008 (online)

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Abstract

A 74-year-old man underwent elective coronary surgery under cardiopulmonary bypass. A few minutes after the protamine administration was started, he suddenly developed a severe Hypotension necessitating cardiac massage and recannulation for pump assistance. A further test dose of protamine provoked an identical reaction. We installed a Heparin Removal Device, which allows for ex-vivo deheparinization. In 35 minutes ACT decreased from 480 sec to 180 sec and clots appeared in the operating field. This system provides an excellent alternative to protamine in patients with an adverse reaction to protamine.

Key words

Cardiopulmonary bypass - Heart surgery - Heparin - Heparin antagonists - Protamine