{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T12:45:57Z","timestamp":1769345157279,"version":"3.49.0"},"reference-count":23,"publisher":"EDP Sciences","issue":"3","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Extra Corpor Technol","JECT"],"accepted":{"date-parts":[[2024,7,8]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>Severe pulmonary vasoconstriction induced by protamine is a rare complication. We report a case of a 77-year-old male patient with a history of mitral valve plasty (MVP). He underwent redo MVP via right thoracotomy under the totally endoscopic procedure (MICS redo-MVP). Immediately after weaning cardiopulmonary bypass (CPB), protamine was administrated. 10\u00a0min later peak systolic pulmonary arterial pressure (sys PAP) rose to 62\u00a0mmHg, and 30\u00a0min later to 80\u00a0mmHg. Due to the negative impact of protamine administration, nitric oxide inhalation (iNO) therapy was started with a concentration of 20\u00a0ppm. 10\u00a0min after iNO therapy started, sys PAP decreased to 63\u00a0mmHg. After entering the intensive care unit (ICU), sys PAP decreased to 35\u00a0mmHg. Here, we present an effective iNO therapy case for pulmonary hypertension due to protamine and the patient had a good postoperative recovery.<\/jats:p>\n<jats:p>This study was approved by the Institutional Review Board at Kitaharima Medical Center (IRB-0602) with the waiver of informed consent.<\/jats:p>","DOI":"10.1051\/ject\/2024018","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T19:07:45Z","timestamp":1721934465000},"page":"120-124","source":"Crossref","is-referenced-by-count":4,"title":["A case of the effective inhalation of nitric oxide therapy for caused severe pulmonary hypertension with protamine neutralization of systemic heparinization during totally endoscopic minimally invasive cardiac surgery"],"prefix":"10.1051","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2344-6219","authenticated-orcid":false,"given":"Tomohisa","family":"Takeichi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihisa","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akitoshi","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"250","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"key":"R1","first-page":"348","volume":"4","author":"Horrow","year":"1985","journal-title":"Anesth Analg"},{"issue":"3","key":"R2","first-page":"505","volume":"88","author":"Ralley","year":"1999","journal-title":"Anesth Analg"},{"issue":"7","key":"R3","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1016\/j.jtha.2023.04.005","volume":"21","author":"Levy","year":"2023","journal-title":"J Thromb Haemost"},{"issue":"2","key":"R4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0022-5223(19)34410-1","volume":"98","author":"Levy","year":"1989","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"5","key":"R5","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1097\/00000542-198311000-00022","volume":"59","author":"Lowenstein","year":"1983","journal-title":"Anesthesiology"},{"issue":"2","key":"R6","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.1742-7843.2008.00274.x","volume":"103","author":"Nybo","year":"2008","journal-title":"Basic Clin Pharmacol Toxicol"},{"issue":"1","key":"R7","doi-asserted-by":"crossref","first-page":"47","DOI":"10.21037\/apm-22-714","volume":"12","author":"Suksompong","year":"2023","journal-title":"Ann Palliat Med"},{"key":"R8","first-page":"547","volume":"6","author":"Lee","year":"2020","journal-title":"Heart Rhythm Case Rep"},{"issue":"6","key":"R9","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1097\/00000542-199112000-00011","volume":"75","author":"Fratacci","year":"1991","journal-title":"Anesthesiology"},{"key":"R10","unstructured":"Horrow J. 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Right ventricular anatomy, function and echocardiographic evaluation. In: Otto C, editor. The practice of clinical echocardiography. 5th ed. 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