Related Experiment Video
Updated: May 17, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Preoperative antithrombin supplementation in cardiac surgery: a randomized controlled trial
Marco Ranucci1, Ekaterina Baryshnikova, Giulia Beatrice Crapelli
1Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy. cardioanestesia@virgilio.it
The Journal of Thoracic and Cardiovascular Surgery
|October 30, 2012
Summary
Preoperative purified antithrombin supplementation in cardiac surgery effectively prevents heparin resistance and maintains adequate antithrombin activity levels postoperatively, improving patient outcomes.
Area of Science:
- Cardiology
- Anesthesiology
- Hematology
Background:
- Heparin resistance and thromboembolic complications are risks in cardiac surgery.
- Purified antithrombin supplementation is a potential treatment strategy.
Purpose of the Study:
- To evaluate the efficacy of preoperative purified antithrombin supplementation.
- Primary endpoint: avoiding low postoperative antithrombin activity (<58%).
- Secondary endpoints: preventing heparin resistance, assessing clinical outcomes and safety.
Main Methods:
- A randomized controlled trial involving 200 patients undergoing cardiac surgery.
- Patients were allocated to either the antithrombin group (received supplementation) or the control group.
- Antithrombin group received a dose to achieve 120% activity.
Main Results:
- Antithrombin group maintained significantly higher postoperative antithrombin activity.
- Zero incidence of antithrombin activity <58% in the antithrombin group vs. 26.6% in controls (P=.001).
- Heparin resistance was significantly lower in the antithrombin group (17%) vs. controls (38.2%) (P=.001).
- Slightly increased bleeding (8 mL/hour) in the antithrombin group, with no difference in transfusion rates.
- No significant differences in clinical outcomes or safety concerns were observed.
Conclusions:
- Preoperative antithrombin supplementation is effective in preventing heparin resistance.
- It successfully avoids excessive postoperative decreases in antithrombin activity.
- This strategy offers a safe approach to managing antithrombin levels during cardiac surgery.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:28Cardiac Catheterization I: Pre-Procedure Overview
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...