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J Thorac Cardiovasc Surg 2006;132:733-734
© 2006 The American Association for Thoracic Surgery


Letter to the Editor

About the activation of the coagulation system during on-pump and off-pump coronary surgery and the use of antifibrinolytic drugs

Valter Casati, MDa, Francisco Guerra, MDb, Armando D'Angelo, MDc

a Division of Cardiovascular Anesthesia and Intensive Care, Policlinico di Monza, via Amati 111, Monza 20052, Italy
b Division of Cardiac Surgery, Policlinico di Monza, via Amati 111, Monza 20052, Italy
c Coagulation Service and Thrombosis Research Unit, Ospedale San Raffaele, Milano, Italy

(Email: valter.casati@policlinicodimonza.it).

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

To the Editor:

The results of the study by Paparella and colleagues1Go recently published in the Journal confirm part of the observations described in previous reports addressing the activation of coagulation and fibrinolysis in coronary surgery performed with (ONCAB) or without (OPCAB) cardiopulmonary bypass (CPB). However, some of the statements contained in their "Discussion" section deserve critical consideration. Because no difference in tissue factor (TF) "production" was observed in the 2 groups of patients while prothrombin fragment 1.2 levels were higher in patients undergoing ONCAB, the authors state that the extrinsic pathway of coagulation should not be considered the only trigger for thrombin formation during CPB. Although the intrinsic pathway might also play a role in thrombin formation during CPB, the observation of circulating levels of TF that are not significantly different does not . . . [Full Text of this Article]


Related Article

Reply to the Editor
Domenico Paparella, Antonella Galeone, and Giuseppe Scrascia
J. Thorac. Cardiovasc. Surg. 2006 132: 734. [Extract] [Full Text] [PDF]



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