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Ann Thorac Surg 2007;83:725-726
© 2007 The Society of Thoracic Surgeons

Correspondence

Reply

Jason A. Williams, MD, William A. Baumgartner, MD

Division of Cardiac Surgery, The Johns Hopkins Hospital, 600 North Wolfe St, Blalock 618, Baltimore, MD 21287

(Email: wbaumgar{at}csurg.jhmi.jhu.edu).

To the Editor:

We would like to thank Drs Veinot and Ruel [1] for bringing up the issue of valproic acid as a cause of increased surgical bleeding. We are aware of this potential complication and appreciate their comments.

In our canine model, we did not see any significant bleeding [2]. However, clearly when we develop a safety trial for this drug and cardiopulmonary bypass, we will list this as one of the potential complicating factors in our informed consent. We also plan to ask our hematology colleagues as to whether there is a better hematology screening method when this drug is given immediately prior to operation. As the authors point out, it is unclear whether this potential bleeding complication is dose related or if it is idiosyncratic.

Once again we appreciate the authors’ comments.


   References
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 References
 

  1. Veinot JP, Ruel M. Valproic acid and bleeding: Caution required (letter) Ann Thorac Surg 2007;83:725.[Free Full Text]
  2. Williams JA, Barreiro CJ, Nwakanma LU, et al. Valproic acid prevents brain injury in a canine model of hypothermic circulatory arrest: a promising new approach to neuroprotection during cardiac surgery Ann Thorac Surg 2006;81:2235-2242.[Abstract/Free Full Text]




This Article
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