ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Jerrold H. Levy
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Levy, J. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Levy, J. H.
Related Collections
Right arrow Extracorporeal circulation

Ann Thorac Surg 2001;72:S1814-S1820
© 2001 The Society of Thoracic Surgeons

Supplement: Mechanisms and attenuation of abnormalities in hemostasis/inflammation and neurologic injury: implications for patient outcomes

Pharmacologic preservation of the hemostatic system during cardiac surgery

Jerrold H. Levy, MD*a

a Division of Cardiothoracic Anesthesiology and Critical Care, Emory University School of Medicine, Emory Healthcare, Atlanta, Georgia, USA

* Address reprint requests to Dr Levy, Department of Anesthesiology, Emory University Hospital, 1364 Clifton Rd, NE, Atlanta, GA 30322, USA
e-mail: jerrold_levy{at}emoryhealthcare.org

Presented at Mechanisms and Attenuation of Abnormalities in Hemostasis/Inflammation and Neurologic Injury: Implications for Patient Outcomes, Vancouver, BC, Canada, May 6, 2001.

Bleeding after cardiac surgery remains a major potential problem. Numerous pharmacologic approaches to attenuating hemostatic system activation in cardiac surgery patients have been studied to further improve patient management. Therapeutic approaches studied include inhibiting thrombin generation or activation, preserving platelet function, and decreasing the need for transfusion of allogeneic blood products. Pharmacologic approaches to reduce bleeding and transfusion requirements in cardiac surgery patients are based on either preventing or reversing the defects associated with the CPB-induced coagulopathy. The increasing use of platelet inhibitors (clopidogrel and IIb/IIIa receptor antagonists) and new anticoagulants (low–molecular weight heparins, pentasaccharide, recombinant hirudin, bivalirudin, and argatroban) also pose interesting problems in managing cardiac surgery patients. Aprotinin and lysine analogues ({epsilon}-aminocaproic acid and tranexamic acid) have become mainstay therapeutic agents to prevent bleeding and the potential need for allogeneic transfusion. Newer therapies that are important to consider include the potential of recombinant activated factor VIIa as a therapy for refractory bleeding after cardiac surgery.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
S. Maltais, L. P. Perrault, and Q.-B. Do
Effect of clopidogrel on bleeding and transfusions after off-pump coronary artery bypass graft surgery: impact of discontinuation prior to surgery.
Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 127 - 131.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
Y. Iwata, O. Nicole, T. Okamura, D. Zurakowski, and R. A. Jonas
Aprotinin confers neuroprotection by reducing excitotoxic cell death
J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 573 - 578.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. R. Cooper Jr, J. Abrams, O.H. Frazier, R. Radovancevic, B. Radovancevic, A. W. Bracey, M. J. Kindo, and I. D. Gregoric
Fatal pulmonary microthrombi during surgical therapy for end-stage heart failure: Possible association with antifibrinolytic therapy
J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 963 - 968.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
L. F. L. Almodovar, P. Lima, A. Canas, and M. Calleja
Fatal anaphylactoid reaction after primary exposure to aprotinin
Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 25 - 26.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Vanek, M. Jares, R. Fajt, Z. Straka, K. Jirasek, M. Kolesar, P. Brucek, and M. Maly
Fibrinolytic inhibitors in off-pump coronary surgery: a prospective, randomized, double-blind TAP study (tranexamic acid, aprotinin, placebo)
Eur. J. Cardiothorac. Surg., October 1, 2005; 28(4): 563 - 568.
[Abstract] [Full Text] [PDF]

Home page
 Toxicol PatholHome page
R. Ponce, K. Armstrong, K. Andrews, J. Hensler, K. Waggie, J. Heffernan, T. Reynolds, and M. Rogge
Safety of Recombinant Human Factor XIII in a Cynomolgus Monkey Model of Extracorporeal Blood Circulation
Toxicol Pathol, October 1, 2005; 33(6): 702 - 710.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. Karski, G. Djaiani, J. Carroll, M. Iwanochko, P. Seneviratne, P. Liu, W. Kucharczyk, L. Fedorko, T. David, and D. Cheng
Tranexamic acid and early saphenous vein graft patency in conventional coronary artery bypass graft surgery: A prospective randomized controlled clinical trial
J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 309 - 314.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
L. Chen, A. W. Bracey, R. Radovancevic, J. R. Cooper Jr, C. D. Collard, W. K. Vaughn, and N. A. Nussmeier
Clopidogrel and bleeding in patients undergoing elective coronary artery bypass grafting
J. Thorac. Cardiovasc. Surg., September 1, 2004; 128(3): 425 - 431.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
L. Shore-Lesserson, K. A. Tanaka, J. H. Levy, S. Pothula, V. T. Sanchala, B. Nagappala, and M. A. Inchiosa Jr.
Antiplatelet Agents and Bleeding After Cardiac Surgery * Response
Anesth. Analg., September 1, 2004; 99(3): 947 - 948.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
B. S. Donahue
Factor V Leiden and Perioperative Risk
Anesth. Analg., June 1, 2004; 98(6): 1623 - 1634.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
L. Shore-Lesserson
New anticoagulants and antiplatelet agents
Can J Anesth, June 1, 2004; 51(suppl_1): R9 - R9.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. Pothula, V. T. Sanchala, B. Nagappala, and M. A. Inchiosa Jr.
The Effect of Preoperative Antiplatelet/Anticoagulant Prophylaxis on Postoperative Blood Loss in Cardiac Surgery
Anesth. Analg., January 1, 2004; 98(1): 4 - 10.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Stratmann, I. A. Russell, and S. H. Merrick
Use of recombinant factor VIIa as a rescue treatment for intractable bleeding following repeat aortic arch repair
Ann. Thorac. Surg., December 1, 2003; 76(6): 2094 - 2097.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
J. A. Green, C. L. Cooper, O. A. Falcucci, A. Safwat, T. Slaughter, B. D. Spiess, and V. G. Nielsen
Argatroban for Off-Pump Coronary Artery Bypass Surgery * Response
Anesth. Analg., October 1, 2003; 97(4): 1201 - 1202.
[Full Text] [PDF]

Home page
 CirculationHome page
B. S. Donahue, D. Gailani, M. S. Higgins, D. C. Drinkwater, and A. L. George Jr
Factor V Leiden Protects Against Blood Loss and Transfusion After Cardiac Surgery
Circulation, February 25, 2003; 107(7): 1003 - 1008.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. A. Nuttall, W. C. Oliver Jr, P. J. Santrach, R. D. McBane, D. B. Erpelding, C. L. Marver, and K. J. Zehr
Patients with a History of Type II Heparin-Induced Thrombocytopenia with Thrombosis Requiring Cardiac Surgery with Cardiopulmonary Bypass: A Prospective Observational Case Series
Anesth. Analg., February 1, 2003; 96(2): 344 - 350.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2001 by The Society of Thoracic Surgeons.