{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:01:57Z","timestamp":1787169717840,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lacteals that result in leakage of excessive serum proteins and lymphocytes into the gastrointestinal (GI) tract culminating in protein-losing enteropathy. The GI loss of protein and possible antithrombin III (AT-III) loss creates a prothrombotic environment. The surgical management of congenital heart disease (CHD) in presence of PIL can present with altered heparin response and can impose problems in instituting cardiopulmonary bypass (CPB). We report a case of surgical closure of ventricular septal defect with PIL with altered heparin response. Such an association of PIL with altered heparin response in CHD has not been reported in literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_197_19","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T06:11:56Z","timestamp":1680243116000},"page":"375-377","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["An unusual cause of heparin resistance - A case report"],"prefix":"10.4103","volume":"24","author":[{"given":"Javid","family":"Raja","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudip D","family":"Baruah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Santhosh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabarinath","family":"Menon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baiju S","family":"Dharan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-19-20240901","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1213\/ANE.0b013e31827e4e62","article-title":"Heparin sensitivity and resistance: Management during cardiopulmonary bypass","volume":"116","author":"Finley","year":"2013","journal-title":"Anesth Analg"},{"key":"R2-19-20240901","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1016\/j.jtcvs.2010.02.038","article-title":"Anticoagulation management during cardiopulmonary bypass: A survey of 54 North American institutions","volume":"139","author":"Lobato","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R3-19-20240901","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1056\/NEJM198306303082601","article-title":"Molecular heterogeneity of inherited antithrombin III deficiency","volume":"308","author":"Prochoownik","year":"1983","journal-title":"N Engl J Med"},{"key":"R4-19-20240901","first-page":"20","article-title":"Loss of inhibitors of the blood coagulation system in protein losing enteropathy","volume":"191","author":"Muntean","year":"1979","journal-title":"Klinische Paediatrie"},{"key":"R5-19-20240901","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/0741-5214(84)90021-1","article-title":"Antithrombin III deficiency as a reflection of dynamic protein metabolism in patients undergoing vascular reconstruction","volume":"1","author":"Flinn","year":"1984","journal-title":"J Vasc Surg"},{"key":"R6-19-20240901","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1080\/20009666.2018.1466599","article-title":"To be or not to be a case of heparin resistance","volume":"8","author":"Durrani","year":"2018","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"R7-19-20240901","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1161\/01.CIR.90.4.2115","article-title":"A 24-year-old man with extensive lower limb edema and acute arterial occlusion","volume":"90","author":"Thandroyen","year":"1994","journal-title":"Circulation"},{"key":"R8-19-20240901","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1111\/j.1468-1331.2006.01656.x","article-title":"Acquired prothrombotic state due to protein-losing enteropathy as a rare cause for ischemic stroke?","volume":"14","author":"Amtage","year":"2007","journal-title":"Eur J Neurol"},{"key":"R9-19-20240901","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1111\/j.1651-2227.2005.tb02026.x","article-title":"Primary intestinal lymphangiectasia: A response to medium-chain triglyceride formula","volume":"94","author":"Koo","year":"2005","journal-title":"Acta Paediatr"},{"key":"R10-19-20240901","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1016\/S0003-4975(03)00894-4","article-title":"Reversal of protein-losing enteropathy with calcium replacement in a patient after Fontan operation","volume":"77","author":"Kim","year":"2004","journal-title":"Ann Thorac Surg"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.ACA_197_19","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:12:29Z","timestamp":1787166749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.ACA_197_19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_197_19","relation":{},"ISSN":["0971-9784"],"issn-type":[{"value":"0971-9784","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}