Management of protamine allergy with bivalirudin during coronary artery revascularization.

Abstract

A patient with impaired left ventricular function was scheduled for coronary artery bypass grafting. The patient's history revealed a life-threatening allergy to fish proteins. Therefore, because of the threat of cross-reactivity to protamine, a standard anticoagulation protocol with heparin/protamine was disapproved. Instead, complete coronary artery revascularization was successfully performed off-pump using bivalirudin as the anticoagulant.

• Authors: Andreas Koster, Ulrich Rosendahl, Eberhard von Hodenberg, Jürgen Ennker
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 90 Issue 1 Pg. 276-7 (Jul 2010) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 20609794 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anticoagulants
• Heparin Antagonists
• Hirudins
• Peptide Fragments
• Protamines
• Recombinant Proteins
• bivalirudin

Topics

• Anaphylaxis (chemically induced, prevention & control)
• Anticoagulants (therapeutic use)
• Coronary Artery Bypass, Off-Pump
• Coronary Artery Disease (surgery)
• Drug Hypersensitivity (prevention & control)
• Heparin Antagonists (adverse effects)
• Hirudins
• Humans
• Male
• Middle Aged
• Peptide Fragments (therapeutic use)
• Protamines (adverse effects)
• Recombinant Proteins (therapeutic use)