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Eur J Cardiothorac Surg 2000;17:760-762
© 2000 Elsevier Science NL

Case report

Undergoing cardiopulmonary bypass using enoxaparin only during a cardiac transplantation procedure

^a Istituto di Chirurgia Toracica, Cardiovascolare e Technologie Biomediche, Università degli Studi di Siena, Siena, Italy
^b Istituto di Chirurgia del Cuore e dei Grossi Vasi, Università degli Studi di Roma, "La Sapienza", Rome, Italy

Corresponding author. Istituto di Chirurgia del Cuore e dei Grossi Vasi, Policlinico Umberto I, Universita degli Studi di Roma ‘La Sapienza’, Viale del Policlinico, 155, 00161, Rome, Italy. Tel.: +-39-6-499-72693; fax: +39-6-499-72410
e-mail: edvinprifti{at}hotmail.com

The use of enoxaparin as a replacement drug to standard heparin, for anticoagulation during extracorporeal circulation, in patients with heparin-induced thrombocytopenia, is still very limited. Enoxaparin significantly reduces thrombin formation and activity during cardiopulmonary bypass. The prolonged circulating rate, slow elimination rate and non-total reversion of enoxaparin by protamine can induce important postoperative bleeding. We are describing the first case of cardiac transplantation where enoxaparin was used as a replacement drug to standard heparin.

Key Words: Enoxaparin • Cardiac transplantation • Heparin-induced thrombocytopenia

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