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Case Reports
. 2019 Sep 15;13(6):211-214.
doi: 10.1213/XAA.0000000000001034.

Non-Antithrombin-Mediated Heparin Resistance During Cardiac Surgery: Two Case Reports

J Kirk Edwards  1 , Roman M Sniecinski, Korrin J Scott
Affiliations
Case Reports

Non-Antithrombin-Mediated Heparin Resistance During Cardiac Surgery: Two Case Reports

J Kirk Edwards et al. A A Pract. .

Abstract

It is well known that antithrombin (AT) deficiency results in decreased heparin sensitivity, also known as "heparin resistance." However, non-AT-mediated causes of heparin resistance are generally poorly characterized and less prevalent in the literature. We present 2 case reports of non-AT-mediated heparin resistance during cardiac surgery due to paraproteinemia and hyperfibrinogenemia. These cases highlight the challenges posed by unusual conditions in achieving adequate anticoagulation for cardiopulmonary bypass (CPB). The pros and cons of the treatment selections for these cases are discussed, and the potential complications of large doses of unfractionated heparin are considered.

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References

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