Abstract | BACKGROUND: Multiple stimuli converge in cardiopulmonary bypass to create a tremendous prothrombotic stimulus. The ideal anticoagulant for cardiopulmonary bypass should selectively target only the intravascular stimuli, thereby eliminating pathologic clotting in the bypass circuit while preserving hemostasis in the thoracic cavity. We propose the inhibition of factor IX as such a targeted anticoagulant strategy. METHODS: RESULTS: CONCLUSIONS: Anticoagulation with activated factor IX allows for intravascular anticoagulation with maintenance of extravascular hemostasis. These findings suggest activated factor IX as an agent that not only exemplifies a targeted approach to selective anticoagulation in cardiac surgery but also further characterizes the procoagulant milieu during cardiopulmonary bypass.
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Authors | T B Spanier, J M Chen, M C Oz, N M Edwards, W Kisiel, D M Stern, E A Rose, A M Schmidt |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 116
Issue 5
Pg. 860-9
(Nov 1998)
ISSN: 0022-5223 [Print] United States |
PMID | 9806393
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anticoagulants
- Factor IX
- Heparin
- Thromboplastin
- Factor IXa
- Thrombin
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Topics |
- Animals
- Anticoagulants
(pharmacology)
- Blood Coagulation Tests
- Blood Loss, Surgical
(physiopathology)
- Cardiopulmonary Bypass
(instrumentation)
- Factor IX
(antagonists & inhibitors, physiology)
- Factor IXa
(antagonists & inhibitors, physiology)
- Heparin
(pharmacology)
- Humans
- Macrophages
(metabolism)
- Microscopy, Electron, Scanning
- Papio
- Surface Properties
- Thrombin
(metabolism)
- Thrombophilia
(blood)
- Thromboplastin
(metabolism)
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