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During routine CPB, high-dose unfractionated heparin (UFH) prevents consumptive coagulopathy and the formation of thrombi within the CPB circuit and the patient's circulation. Prior treatment with andexanet alfa can pose difficulties in achieving adequate anticoagulation during CPB with UFH. The administration of antithrombin, in combination with UFH, may overcome these difficulties.
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Mechanical Circulatory Support to Treat Pulmonary Embolism: Venoarterial Extracorporeal Membrane Oxygenation and Right Ventricular Assist Devices
For patients with massive pulmonary embolism who are not candidates for conventional interventions or whose conditions are refractory, mechanical circulatory support in the form of RVAD placement or ECMO may be considered. Larger comparative studies are needed.
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