[Cardiac Surgery Using Low-dose Heparin Combined with Nafamostat Mesilate in an Acute Hemorrhagic Stroke]

A 66-year-old man presented to our hospital complaining palpitation and fatigue. He was diagnosed with heart failure secondary to mitral regurgitation, left ventricular thrombus, and hemorrhagic stroke in right cerebral hemisphere. Cardiac surgery under cardiopulmonary bypass during acute phase of stroke or cerebral hemorrhage carries significant risk, including exacerbation of neurological complications due to intraoperative anticoagulation. To mitigate this risk, we employed a low-dose heparin regimen combined with nafamostat mesilate continuous infusion during surgery. The patient successfully underwent mitral valve plasty and left ventricular thrombectomy, with a favorable postoperative course and no new neurological deficits.