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J Thorac Cardiovasc Surg 2005;130:1455-1456
© 2005 The American Association for Thoracic Surgery

Brief Communication

Heparin allergy: Successful desensitization for cardiopulmonary bypass

Kalpaj Parekh, MD a , Harold M. Burkhart, MD a , * , Ammar Hatab, MD b , Alan Ross, MD c , Barbara A. Muller, MD b

a Department of Surgery, Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
b Department of Medicine, Division of Allergy and Immunology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
c Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Received for publication March 16, 2005; revisions received April 16, 2005; accepted for publication May 2, 2005.

* Address for reprints: Harold M. Burkhart, MD, Department of Surgery, Division of Cardiothoracic Surgery, 200 Hawkins Dr, Iowa City, IA 52242. (Email: harold-burkhart@uiowa.edu).

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

Heparin remains the drug of choice required for anticoagulation during cardiopulmonary bypass. Advantages of heparin over other drugs are its rapid onset of action after intravenous administration and its rapid reversibility with protamine. Heparin-induced anaphylaxis, although rare, has been reported. 1 Go We report successful desensitization to heparin in a patient requiring pulmonary valve replacement.

Clinical Summary

A 55-year-old woman with a history of a tetralogy of Fallot repair done at age 10 years presented with congestive heart failure. Transesophageal echocardiography and cardiac catheterization revealed free pulmonary valve insufficiency requiring replacement. The medical history was significant for heparin allergy first observed at the time of the original cardiac surgery in 1959. She had generalized hives and itching immediately after surgical intervention that was thought to be attributable to heparin infusion. In 1970, she experienced pulmonary embolism and was re-exposed to intravenous heparin, triggering . . . [Full Text of this Article]




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[Abstract] [PDF]


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