{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:01:37Z","timestamp":1777917697714,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2000,12,1]],"date-time":"2000-12-01T00:00:00Z","timestamp":975628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2000,12]]},"abstract":"<jats:p>The serine protease inhibitor antithrombin-III (AT-III) is the principal in vivo inhibitor of blood coagulation, inactivating mainly thrombin, but also other serine proteases. Binding of AT-III to heparin dramatically increases its inhibitory effect. AT-III deficiency during cardiopulmonary bypass (CPB) can lead to insufficient anticoagulation which cannot be treated by higher doses of heparin.<\/jats:p>\n                  <jats:p>\n                    A 60-year-old male with familial AT-III deficiency was admitted to our hospital for coronary artery bypass surgery and aortic valve replacement. Four days before the operation, acenocoumarol was stopped and anti-X\n                    <jats:sub>a<\/jats:sub>\n                    nadroparincalcium (Fraxiparine) was started. AT-III activity at that time was 56%. Two hours before the operation, a single dose of 4500 IU AT-III concentrate was administered. Heparinization was performed with 400 IU\/kg of porcine mucosal heparin, increasing the activated coagulation time (ACT) from a baseline of 115 to 549 s. AT-III activity at that time was above 100% and the plasma D-dimer concentration was 230 ng\/l. ACTs during CPB remained above 999 s, whereas the AT-III activity dropped to 54% and the D-dimer increased up to 500 ng\/l at the end of CPB. CPB was terminated uneventfully. Heparin was reversed with 3 mg\/kg protamine chloride, decreasing the ACT to 155 s. In the intensive care unit (ICU), the patient received prophylactic Fraxiparine and 1500 IU AT-III, increasing the AT-III activity to 84%. Postoperatively, there was continued blood loss, which necessitated the administration of whole blood and eventually re-exploration.\n                  <\/jats:p>\n                  <jats:p>The case presented illustrates an uneventful treatment of a patient with a hereditary AT-III deficiency undergoing CPB. In spite of an uneventful treatment with AT-III pre-CPB, administration of prophylactic AT-III concentrate after surgery should be considered with caution, as this might increase the postoperative morbidity.<\/jats:p>","DOI":"10.1177\/026765910001500613","type":"journal-article","created":{"date-parts":[[2013,1,23]],"date-time":"2013-01-23T17:18:45Z","timestamp":1358961525000},"page":"553-556","source":"Crossref","is-referenced-by-count":6,"title":["Familial antithrombin-III deficiency during cardiopulmonary bypass: a case report"],"prefix":"10.1177","volume":"15","author":[{"given":"H J","family":"Brinks","sequence":"first","affiliation":[{"name":"Department of Extracorporeal Circulation, University Medical Centre St.                         Radboud, Nijmegen,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P W","family":"Weerwind","sequence":"additional","affiliation":[{"name":"Department of Extracorporeal Circulation, University Medical Centre St.                         Radboud, Nijmegen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M WA","family":"Verkroost","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Medical Centre St.                         Radboud, Nijmegen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Nov\u00e1kov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Haematology, University Medical Centre St. Radboud, Nijmegen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M HJ","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department Cardiothoracic Surgery, University Medical Centre St. Radboud, Nijmegen"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2000,12,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(18)30284-3"},{"key":"atypb2","first-page":"71","volume-title":"Blood: Haemostasis transfusion, and alternatives in the perioperative period","author":"Campell FW","year":"1995"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(89)80531-5"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1097\/00001721-199401000-00002"},{"key":"atypb5","first-page":"1199","volume-title":"Hemostasis and thrombosis: basic principles and clinical practice","author":"Hirsch J","year":"1987"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/73.5.723"},{"key":"atypb7","first-page":"19","volume":"28","author":"Hathaway WE.","year":"1991","journal-title":"Sem Hematol"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)90752-8"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-0770(97)90172-5"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)41741-8"},{"issue":"5","key":"atypb11","first-page":"II420","volume":"88","author":"Teoh KH","year":"1993","journal-title":"Circulation"},{"key":"atypb12","first-page":"721","volume":"59","author":"Frick PG","year":"1966","journal-title":"Surgery"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/026765910001500613","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/026765910001500613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:20:45Z","timestamp":1777659645000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/026765910001500613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2000,12]]}},"alternative-id":["10.1177\/026765910001500613"],"URL":"https:\/\/doi.org\/10.1177\/026765910001500613","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,12]]}}}