Details

Autor(en) / Beteiligte

• Lemmer, John H
• Metzdorff, Mark T
• Krause, Albert H
• Martin, M.Alan
• Okies, J.Edward
• Hill, Jon G

Titel

Emergency coronary artery bypass graft surgery in abciximab-treated patients

Ist Teil von

• The Annals of thoracic surgery, 2000-01, Vol.69 (1), p.90-95

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2000

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Background. Although the platelet antiaggregant abciximab is frequently used with percutaneous coronary interventions, results of emergency coronary artery bypass graft operations in patients recently treated with abciximab are poorly characterized. Methods. During a 29-month period, 12 patients required emergency coronary artery bypass grafting within 12 hours (mean, 1.9 hours) of abciximab therapy. Our full standard heparin dose regimen was used (mean heparin dose, 53,000 U per patient). Each patient received a single platelet transfusion dose after protamine administration, and further blood products were transfused as necessary. Clinical outcome and transfusion requirements were compared with predicted results based on risk-adjusted historical patients. Results. No patients died and none were returned to the operating room for coagulopathy-related bleeding. Per-patient transfusion requirements were as follows: red blood cells, 3.6 units; apheresis platelets, 1.4 units; and fresh frozen plasma, 1.5 units. As compared with predicted values, there was no excessive incidence of mortality, stroke, or red blood cell transfusion requirements. Conclusions. Emergency coronary artery bypass graft operations using full-dose heparin can be performed successfully in acutely ischemic abciximab-treated patients. Prophylactic transfusion of platelets after protamine administration appears to be useful.