[The use of low-molecular weight heparins for the intraoperative ischemic damage of the myocardium in patients undergoing surgery with extracorporeal circulation].

The purpose of the work was study of the possibility of intraoperative use of low-molecular heparins (LMH) in postperfusion ischemic damages to the myocardium (IDM) in cardiosurgical patients. The data on 26 patients who underwent operation on the heart under extracorporeal circulation for ischemic heart disease are discussed. All patients had IDM in the postperfusion period. A marked tendency to wards hypercoagulation in restoration of blood coagulation at the end of the perfusion period was recorded in all patients. LMH was used during the operation in 12 patients to prevent thrombosis. Fraxiparine was infused intravenously in a dose of 100 anti-fX-IU/kg after IDM recording on the ECG. Fraxiparine was not administered during the operation in 14 patients. It was applied in all patients in the early postoperative period in the form of 2 intravenous infusions given in the first 24 h after the operation. It was established that LMH are the only group of drugs allowing antithrombotic prevention to be started in the postperfusion period in cardiosurgical patients with intraoperative IDM. Intraoperative LMH administration reduces the hypercoagulative changes in the blood coagulation system, does not increase significantly the blood loss, and does not prevent the performance of surgical hemostasis.