TITLE

Plasma sequestration: a good therapy to prevent the deleterious effect of clopidogrel when clopidogrel is used within one to four days of coronary bypass surgery

AUTHOR(S)
Schill, David M.
PUB. DATE
March 2010
SOURCE
Perfusion;Mar2010, Vol. 25 Issue 2, p91
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Clopidogrel (Plavix) is an inhibitor of ADP-induced platelet aggregation, acting by direct inhibition of adenosine diphosphate (ADP) binding to its receptor and of the subsequent ADP-mediated activation of the glycoprotein GPIIb/IIIa complex. A common recommendation for coronary artery bypass surgery is to stop clopidogrel five to seven days before surgery.1 Patients taking clopidogrel within five days of surgery are more likely to show an increase in post-operative bleeding, an increase need for blood products, and an increased chance for secondary operations to control bleeding. This paper presents an option which appears to decrease the adverse effects of clopidogrel for patients undergoing coronary artery bypass surgery within one to four days of stopping the use of clopidogrel. This option is autologous plasma sequestration. The process of plasma sequestration collection prior to the administration of heparin during surgery offers a significant therapy to minimize bleeding post bypass. Twelve consecutive patients are included in this study (one a REDO) each receiving clopidogrel within one to four days of surgery. Throughout their hospital stay, three patients required packed red blood cell (RBC) transfusions (two received 2 units, one received 1 unit). No other donor blood products were required. Post-operative bleeding was minimal, and the need for a secondary operation due to bleeding was eliminated. The average stay in the cardiovascular intensive care unit(CICU) was 2.8 days, with an average hospital stay of 7.25 days.
ACCESSION #
50229748

 

Related Articles

  • Clopidogrel Within Few Hours of Coronary Artery Bypass Grafting Does Significantly Increase the Risk of Bleeding. Hijazi, Emad M.; Musleh, Ghassan S. // Cardiology Research;2012, Vol. 3 Issue 5, p209 

    Background: Postoperative bleeding after coronary artery surgery is partly related to platelet dysfunction. The aim of this study was to evaluate the effects of a single loading dose of clopidogrel (300 mg) before coronary angiography on bleeding and use of blood and blood products after...

  • Miniaturized versus conventional cardiopulmonary bypass in high-risk patients undergoing coronary artery bypass surgery. Koivisto, Simo-Pekka; Wistbacka, Jan-Ola; Rimpiläinen, Riikka; Nissinen, Juha; Loponen, Pertti; Teittinen, Kari; Biancari, Fausto // Perfusion;Mar2010, Vol. 25 Issue 2, p65 

    Objective: To review our results with the use of miniaturized cardiopulmonary bypass (Mini-CPB) versus conventional cardiopulmonary bypass (C-CPB) in high-risk patients (additive EuroSCORE≥6) who have undergone coronary artery bypass graft surgery (CABG). Patients and methods: This study...

  • DISCUSSION. Raithel, Dieter // Vascular Surgery;Sep/Oct1998, Vol. 32 Issue 5, p517 

    The author reflects on the study of a patient with myonephropatic metabolic syndrome after bilateral aortoiliac bypass. He presented the findings of the study. He also commented that the researcher was correct to point out that the blue-toe syndrome is an avoidable complication when the outflow...

  • Grow your own arteries. Coghlan, Andy // New Scientist;01/24/98, Vol. 157 Issue 2118, p6 

    Reports that blood vessels for bypass surgery can be developed from the patient's tissue. Details on a technique developed by research team at the Laval University School of Medicine in Quebec, Canada; Discussion on the blood vessels; Comments from Nicolas L'Heureux a member of the Laval team...

  • Lab veins could bypass surgery.  // South Asian Post;2/10/2011, p10 

    The article reports that U.S. researchers have created 37 human blood vessels produced from donated human muscle tissue which is believed that it can revolutionise bypass surgery.

  • MINERVA.  // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;1/15/2011, Vol. 342 Issue 7789, p178 

    This section discusses various studies related to medicine. A study published in "Nature Neuroscience," revealed that the size of the amygdala correlates with the size and complexity of social networks in adults. Another study, which appeared in "Circulation," showed that clopidogrel inhibits...

  • ENDOVASCULAR TECHNIQUES IN LIMB SALVAGE: STENTS. El-Sayed, Hosam F. // Methodist DeBakey Cardiovascular Journal;Apr/June2013, Vol. 9 Issue 2, p79 

    In patients with critical limb ischemia, the first-line approach for limb salvage has shifted over the past decade from bypass surgery to endovascular intervention. Stenting for the treatment of lower-extremity arterial occlusive disease is an important tool and continues to evolve, with new...

  • Endoscopic harvest of saphenous vein: a lesson learned from 1,348 cases. Chiu, K.-M.; Chen, C.-L.; Chu, S.-H.; Lin, T.-Y. // Surgical Endoscopy;Jan2008, Vol. 22 Issue 1, p183 

    Endoscopic harvest of saphenous vein is a relatively new technique developed to minimize the wound and postoperative complications. This technique has gained patients’ acceptance and become popular in cardiac surgical practices. Because most centers have limited experience with this...

  • HORMONE REPLACEMENT THERAPY TO PREVENT CORONARY EVENTS. Richard, Dan; Newton, Warren P. // Journal of Family Practice;Nov1998, Vol. 47 Issue 5, p333 

    This article discusses research done on the feasibility of using hormone replacement therapy (HRT) to prevent coronary events in post-menopausal women with coronary artery . Coronary artery disease is described as having a myocardial infarction, coronary artery bypass graft, or percutaneous...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics