Cardiopulmonary bypass strategy with low-dose heparin and nafamostat mesilate in cardiac surgery: A safe option for patients with acute stroke

摘要

Patients undergoing open cardiac surgical procedures with a history of acute stroke pose a difficult management problem. There is always the risk that cardiopulmonary bypass (CPB) and heparinization may induce intracranial hemorrhage. A multicenter study suggests that open cardiac surgical procedures can be performed safely 4 weeks after stroke; however, some patients with acute cardiogenic stroke occasionally require emergency surgery because of uncontrollable heart failure or ongoing thromboembolism. Heparinized CPB with low systemic heparinization is among the therapeutic options when operating on patients with the risk of intracranial hemorrhage; however, low systemic heparinization could allow clot formation.