Anticoagulation Management in Complex Cardiac Surgery

Impact on Anticoagulation Management When Activated Clotting Time is Combined With Heparin Concentration Monitoring in Cardiac Surgery: a Randomised Clinical Trial

The goal of this clinical trial is to compare the anticoagulation management with or without heparin concentration level guidance, in patients undergoing valve or complex cardiac surgery during cardiopulmonary bypass using closed, coated circuits. The main questions it aims to answer are:

• initial heparin bolus, subsequent supplementary doses and total heparin variance among groups.
• protamine dose among groups.

Participants are adult patients scheduled for valve or complex cardiac surgery. They are randomised to either Activated Clotting Time guided management alone or combined with heparin level concentration monitoring.

Inclusion Criteria:

• elective procedures
• cardiac surgery, except for Coronary Artery Bypass Grafting
• Cardiopulmonary bypass under Minimally Invasive Extracorporeal Circulation

Exclusion Criteria:

• known allergy to heparin or protamine
• hematological disease