Emergency coronary artery bypass graft surgery in abciximab-treated patients
| Autor: | Jon G Hill, John H Lemmer, Albert H. Krause, J.Edward Okies, M. Alan Martin, Mark T Metzdorff |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Time Factors medicine.drug_class Abciximab Myocardial Ischemia Platelet Glycoprotein GPIIb-IIIa Complex Platelet Transfusion Risk Assessment Immunoglobulin Fab Fragments Plasma medicine Humans Blood Transfusion Protamines Coronary Artery Bypass Stroke Aged business.industry Heparin Incidence Anticoagulant Plateletpheresis Antibodies Monoclonal Anticoagulants Heparin Antagonists Middle Aged medicine.disease Surgery Survival Rate medicine.anatomical_structure Platelet transfusion Apheresis Treatment Outcome Anesthesia Female Fresh frozen plasma Cardiology and Cardiovascular Medicine business Erythrocyte Transfusion Platelet Aggregation Inhibitors Artery medicine.drug Forecasting |
| Zdroj: | The Annals of thoracic surgery. 69(1) |
| ISSN: | 0003-4975 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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