Journal of cardiac surgery
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Patients with heparin-induced thrombocytopenia II (HIT II) need an alternative nonheparin-based method of anticoagulation for cardiopulmonary bypass (CPB) to prevent thrombosis and thrombosis related complications. ⋯ Anticoagulation was successfully managed with bivalirudin, a new short-acting, and direct thrombin inhibitor. Further studies are necessary to evaluate the safety of bivalirudin during DHCA.
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The circadian variation that affects atherosclerosis has not been studied in the surgical patient. The circadian variation in mortality dependent on the time of surgery was examined in patients undergoing coronary artery bypass graft (CABG) surgery. ⋯ The mortality for nonemergent CABG is independent of the timing of surgery. Circadian variation does not influence the outcome in cardiac surgical patients.