Is Bovine Heparin, an Old Fellow, a Safe Anticoagulation Approach during Extracorporeal Circulation Inside the Cardiac Operating Room?

Antithrombotic agents include anticoagulants, antiplatelet and fibrinolytic drugs. They are prescribed in several situations related to hemostasis disturbances that favor thrombi formation. Since bleeding is a common adverse effect of these drugs, a cost-benefit analysis of antithrombotic therapy prior to surgery should be performed. In order to consider the preoperative therapy for patients undergoing cardiac surgery, the risk of thrombosis must outweigh the risk of bleeding. Nonetheless, the literature has reported the use of anticoagulant therapy with unfractionated heparin (UFH) during extracorporeal circulation (ECC) inside and outside the cardiac operating room. ^–

The development of the heart-lung machine made ECC possible. Therefore, heart surgery became a routine practice. The literature describes that complications related to ECC have diminished due to modern monitoring, highly trained staff, special cannulation methods, as well as the latest advances in techniques. However, some authors suggest that guidelines based on more researches would improve the safety of this procedure. During cardiac surgery, ECC preserves the functional characteristics of the heart, provides a clean surgical environment and offers safety to the team.

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