Severe Protamine Reaction During Multivalvular Cardiac Surgery
Document Type
Conference Proceeding - Restricted Access
Publication Date
10-10-2021
Abstract
A 76-year-old female with a history of hypertension, atrial fibrillation, severe mitral regurgitation, severe tricuspid regurgitation, diabetes mellitus and multiple allergies presented for mitral valve replacement and tricuspid valve repair. After weaning off cardiopulmonary bypass, protamine was administered slowly and a severe decrease in blood pressure and increase in pulmonary artery pressure was observed. There was minimal improvement in hemodynamics despite halting protamine infusion, volume resuscitation and epinephrine boluses. After reassessment with TEE, initiation of milrinone and inhaled nitric oxide therapy ultimately proved valuable in obtaining hemodynamics stability. This case discusses the risk factors, prevention, treatment and types of protamine reactions.
Recommended Citation
Daklallah Y, Lau W. Severe protamine reaction during multivalvular cardiac surgery. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/4898
Comments
American Society of Anesthesiology Annual Meeting, San Diego, CA, October 8-12, 2021.