HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Gino Gerosa Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bottio, T. Articles by Gerosa, G. Search for Related Content PubMed PubMed Citation Articles by Bottio, T. Articles by Gerosa, G. Related Collections Congestive Heart Failure

J Thorac Cardiovasc Surg 2003;126:1194-1195
© 2003 The American Association for Thoracic Surgery

Brief communication

Life-threatening anaphylactic shock caused by porcine heparin intravenous infusion during mitral valve repair

^a Department of Cardiovascular Surgery, University of Padua, Padua, Italy
^b Department of Anesthesiology, University of Padua, Padua, Italy
^c Department of Allergology, University of Padua, Padua, Italy

Received for publication May 5, 2003; accepted for publication May 12, 2003.

^* Address for reprints: Tomaso Bottio, MD, Institute of Cardiovascular Surgery, Via Giustiniani, 2, 35128 Padova, Italy
tomaso.bottio@unipd.it

The first 20% of the full text of this article appears below.

Dr Bottio

Adverse skin reactions to low-molecular-weight heparin and systemic allergic reactions coupled with heparin-induced antibody reactions have been described.^1-3 In this report we describe a case of cardiogenic anaphylactic shock caused by porcine gut heparin infusion in the cardiac surgery theater before starting cardiopulmonary bypass (CPB) in a young man with degenerative mitral valve incompetence.

Clinical summary

A 36-year-old man was referred to the Cardiovascular Institute of Padua University for mitral valve repair of valve incompetence caused by a floppy valve. He had a history for asthma treated with ß-stimulants and a documented Acarus species allergy. He had mitral valve incompetence for about 6 years, which more recently progressed to New York Heart Association class II. Physical examination revealed significant systolic murmur (5/6 grade). Electrocardiography disclosed normal sinus rhythm (97 beats/min), mild left ventricular hypertrophy, and an enlarged atrial component. The hematologic and biochemical values were within normal range. Chest radiography showed an increased cardiothoracic ratio. Two-dimensional echocardiography showed severe mitral regurgitation and left atrial and ventricular dilatation with a normal ejection fraction. These data were confirmed by cardiac angiography with hemodynamic study. The spirometry analysis showed mild airways obstruction with reduced tidal volume.

After providing written informed consent, the patient received premedication consisting of 2 . . . [Full Text of this Article]

This article has been cited by other articles:

				J. H. Levy and N. F. Adkinson Jr Anaphylaxis During Cardiac Surgery: Implications for Clinicians Anesth. Analg., February 1, 2008; 106(2): 392 - 403. [Abstract] [Full Text] [PDF]

				F. Pappalardo, A. Franco, G. Crescenzi G, A. Poli, A. Zangrillo, and A. Koster Successful use of bivalirudin for cardiopulmonary bypass in a patient with heparin allergy Perfusion, January 1, 2007; 22(1): 67 - 69. [Abstract] [PDF]

				K. Parekh, H. M. Burkhart, A. Hatab, A. Ross, and B. A. Muller Heparin allergy: Successful desensitization for cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., November 1, 2005; 130(5): 1455 - 1456. [Full Text] [PDF]