OnPump CPB Cardiac Surgery

The EVOLUTION-ON study was also recently completed. This trial compared bivalirudin to UFH with protamine reversal in patients undergoing cardiac surgery with CPB (Dyke et al., 2006). Bivalirudin was used in 98 patients vs. UFH and protamine in 52 individuals. There was no significant difference in procedural success (absence of death, non-Q wave MI, stroke, repeat revascularization) in the two groups, although early post-operative blood loss and a numerically higher rate of reoperation for bleeding (5.1% vs. 1.9%) were reported in the bivalirudin group (Warkentin, 2006). Secondary endpoints, including 24-h blood loss and overall incidence of transfusions, were similar between the two study arms (Dyke et al., 2006).

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