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Eur J Cardiothorac Surg 2003;24:325-327
© 2003 Elsevier Science NL

Case report

Dramatic post-cardiotomy outcome, due to severe anaphylactic reaction to protamine

A. Panos*, X. Orrit, C. Chevalley, A. Kalangos

Clinic for cardio-vascular surgery, Department of Surgery, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland

Received 17 December 2002; received in revised form 28 March 2003; accepted 1 April 2003.

* Corresponding author. Tel.: +41-223727624; fax: +41-223727634
e-mail: aristotepanos{at}yahoo.com

Immunologic reactions to protamine sulfate during cardiac surgery are very rare. The frequency and outcome of such adverse reactions is unclear. We report a case of lethal anaphylactic reaction to protamine that occurred in a non-diabetic patient following the uneventful replacement of the ascending aorta. We also briefly review the mechanisms of this adverse reaction and emit some considerations on the management of this situation.

Key Words: Cardiac surgery • Protamine • Allergy




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Copyright © 2003 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.