Selective anticoagulation with active site-blocked factor IXa suggests separate roles for intrinsic and extrinsic coagulation pathways in cardiopulmonary.

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Presentation transcript:

Selective anticoagulation with active site-blocked factor IXa suggests separate roles for intrinsic and extrinsic coagulation pathways in cardiopulmonary bypass Talia B. Spanier, MDa, Jonathan M. Chen, MDa, Mehmet C. Oz, MDa, Niloo M. Edwards, MDa, Walter Kisiel, PhDb, David M. Stern, MDc, Eric A. Rose, MDa, Ann Marie Schmidt, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 116, Issue 5, Pages 860-869 (November 1998) DOI: 10.1016/S0022-5223(98)00437-1 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 1 Divergent role of factor IX in the procoagulant response in the setting of low (intrinsic system) or high (extrinsic system) levels of TF. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 860-869DOI: (10.1016/S0022-5223(98)00437-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 2 Scanning electron microscopy of the CPB filters. CPB performed in animals treated with factor IXai was associated with comparable clinically inapparent fibrin deposition on arterial filters (left panel) when compared with animals treated with heparin (right panel). Original magnification is indicated. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 860-869DOI: (10.1016/S0022-5223(98)00437-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 3 Analysis of thrombin generation in baboons undergoing CPB. Baboons underwent CPB with either IXai (solid line) or heparin/protamine (dashed line). A, At the indicated times, blood was withdrawn from a peripheral arterial line for analysis by ELISA for TAT and prothrombin activation peptide (F1+2). B, Compared with heparin-treated animals, animals treated with IXai revealed significantly increased levels of both markers. *P < .05, by ANOVA. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 860-869DOI: (10.1016/S0022-5223(98)00437-1) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 4 Anti-TF IgG or nonimmune (mouse) IgG-stained sections of pericardium (original magnification ×25) revealed striking TF expression (A) in pericardial macrophages, (B) in the vasculature that pervade pericardial tissue, or (C) in pericardial mesothelial cells; (D) staining of an adjacent section with nonimmune IgG was negative. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 860-869DOI: (10.1016/S0022-5223(98)00437-1) Copyright © 1998 Mosby, Inc. Terms and Conditions