{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:28:40Z","timestamp":1777915720417,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,2,2]],"date-time":"2019-02-02T00:00:00Z","timestamp":1549065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Central venoarterial extracorporeal membrane oxygenation has been used since the 1970s to support patients with cardiogenic shock following cardiac surgery. Despite this, in-hospital mortality is still high, and although rare, thrombus within the cardiac chambers or within the extracorporeal membrane oxygenation circuit is often fatal. Aprotinin is an antifibrinolytic available in Europe and Canada, though not currently in the United States. Due to historical safety concerns, use of aprotinin is generally limited and is commonly reserved for patients with the highest bleeding risk. Given the limited availability of aprotinin over the last decade, it is not surprising to find a complete absence of literature describing the use of venoarterial extracorporeal membrane oxygenation in the presence of aprotinin. We present three consecutive cases of rapid fatal intraoperative intracardiac thrombosis associated with post-cardiotomy central venoarterial extracorporeal membrane oxygenation in patients receiving aprotinin.<\/jats:p>","DOI":"10.1177\/0267659119826822","type":"journal-article","created":{"date-parts":[[2019,2,2]],"date-time":"2019-02-02T07:23:20Z","timestamp":1549092200000},"page":"417-421","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Three consecutive cases of fatal intraoperative intracardiac thrombosis associated with the initiation of venoarterial extracorporeal membrane oxygenation in the presence of aprotinin"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0920-2795","authenticated-orcid":false,"given":"Chris","family":"Oscier","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinmay","family":"Patvardhan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Falter","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Will","family":"Tosh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Dunning","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Catarino","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"DeSilva","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Besser","sequence":"additional","affiliation":[{"name":"Department of Haematology, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamen","family":"Valchanov","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,2,2]]},"reference":[{"key":"bibr1-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2017.11.017"},{"key":"bibr2-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.12.003"},{"key":"bibr3-0267659119826822","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1051\/ject\/201648162","volume":"48","author":"Williams B","year":"2016","journal-title":"J Extra Corpor Technol"},{"key":"bibr4-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.02.029"},{"key":"bibr5-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)91190-1"},{"key":"bibr6-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.00724.x"},{"key":"bibr7-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051379"},{"key":"bibr8-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.5.471"},{"key":"bibr9-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802395"},{"key":"bibr10-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707768"},{"key":"bibr11-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707571"},{"key":"bibr12-0267659119826822","unstructured":"Medscape, https:\/\/www.medscape.com\/viewarticle\/832483 (accessed 10 October 2018)."},{"key":"bibr13-0267659119826822","unstructured":"European Medicines Agency assessment report, https:\/\/www.ema.europa.eu\/documents\/referral\/assessment-report-antifibrinolytic-medicines-Aprotinin_en.pdf (2013, accessed 10 October 2018)."},{"key":"bibr14-0267659119826822","unstructured":"Extracorporeal Life Support Organization (ELSO). General guidelines for all ECLS cases August, 2017, https:\/\/www.elso.org\/Portals\/0\/ELSO%20Guidelines%20General%20All%20ECLS%20Version%201_4.pdf (accessed 10 October 2018)."},{"key":"bibr15-0267659119826822","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.10.01"},{"key":"bibr16-0267659119826822","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-016-0625-4"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0267659119826822","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0267659119826822","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0267659119826822","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:27:55Z","timestamp":1777656475000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0267659119826822"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,2]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1177\/0267659119826822"],"URL":"https:\/\/doi.org\/10.1177\/0267659119826822","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,2]]}}}