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J Thorac Cardiovasc Surg 1999;117:1032-1034
© 1999 Mosby, Inc.

BRIEF COMMUNICATIONS

REOPRO REMOVAL DURING CARDIOPULMONARY BYPASS USING A HEMOCONCENTRATOR

From the Department of Cardiothoracic Surgery, Hammersmith Hospital, London, United Kingdom

Received for publication Dec 2, 1998 Accepted for publication Dec 15, 1998 Adddress for reprints: Michael Poullis, MD, Department of Cardiothoracic Surgery, Hammersmith Hospital, Du Cane Rd, East Action, London W12 ONN, United Kingdom.

ReoPro (abciximab) is the Fab fragment of a monoclonal antibody raised in mice against platelet glycoprotein IIb/IIIa complex (Gp11b-IIIa) that is present on the surface of platelets. Administration of this monoclonal antibody fragment results in almost total inhibition of platelet aggregation. ¹ ReoPro has proved to be a major advance in the field of interventional cardiology, especially during coronary angioplasty and coronary stenting. Unfortunately, some patients treated with ReoPro remain unstable or develop unstable angina after intervention. Cardiac surgery is then dangerous because of the excessive bleeding that may occur in patients who have received ReoPro. ^2,3 Since the bleeding that can occur can be so catastrophic that patients have died as a result, patients may be turned down by cardiac surgeons, or not referred at all. Manufacturer guidelines (Eli Lilly and Company, Ltd) recommend that any patient undergoing surgery after the administration of ReoPro should receive 10 units of platelets to absorb free ReoPro in the plasma. The transfusion of this large number of platelets is not only costly but also associated with significant side effects. At some smaller surgical units, sufficient platelets may simply not be available at short notice. Scattered case reports of successful cardiac surgery after the administration of ReoPro are in the literature, but none of the . . . [Full Text of this Article]

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