Heparin dose, transfusion rates, and intraoperative graft patency in XXXX .

@entity1 @entity254 @entity1372 @entity453 @entity715
BACKGROUND: Many investigators have demonstrated the short-term and midterm efficacy of @entity453 ( @entity453 ). However, the influence of heparin dosing during @entity453 on postoperative and immediate graft patency is less well defined. This report outlines our experience with @entity453 employing a variety of heparinization protocols. METHODS: The traditional @entity453 approach was used in 152 @entity1 who underwent single-vessel off-pump coronary artery bypass. Before the left internal mammary artery was divided, a 150-U/kg bolus of heparin @entity1372 was given to 76 @entity1 (group 1), and 300 U/kg was given to another 76 @entity1 (group 2). Additional heparin was given during the procedures to maintain an activated clotting times of greater than 300 seconds for group 1 and greater than 400 seconds for group 2. RESULTS: On average, @entity1 in group 1 required more boluses of heparin during treatment than @entity1 in group 2. A larger standard deviation from the mean was observed for the activated clotting time in group 1 at any time during treatment than for @entity1 in group 2. The number of revised grafts was smaller in group 2 (1/76, 1.3%) than in group 1 (4/76, 5.2%). All of these revisions revealed @entity715 at the site of @entity254 . In addition, noncoronary thrombotic complications were seen in 5 @entity1 in group 1, and none were seen in group 2. CONCLUSION: Coronary artery surgery without cardiopulmonary bypass does not trigger the systemic inflammatory response, but surgical tissue trauma remains a constant. The preserved hemostasis theoretically may lead to a procoagulant state. This study demonstrates that insufficient anticoagulation therapy can lead to intracoronary @entity715 following @entity453 as well as @entity715 .
