Abstract

Bleeding is common after cardiac surgery and is associated with increased morbidity and mortality. The etiology of coagulopathy after cardiopulmonary bypass is complex, involving systemic inflammation, hemodilution, residual heparin effect, platelet activation, hypothermia, and hyperfibrinolysis. Antifibrinolytic agents such as aprotinin and lysine analogs are used to mitigate hyperfibrinolysis. Although epsilon-aminocaproic acid (EACA) is generally considered safe, dosing regimens vary, and thrombotic complications are underreported in national registries. We describe a case of acute intracardiac thrombosis shortly after EACA administration during mitral valve repair in a patient with no known hematologic or hypercoagulable conditions. .

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleCase Reports

Indexed MeSH termsHumansAminocaproic AcidAntifibrinolytic AgentsMitral ValveMitral Valve InsufficiencyThrombosis

Summary

Peer-reviewed research on safety and infection-control considerations relevant to leech therapy and anticoagulation. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This case report describes acute intracardiac thrombosis occurring shortly after epsilon-aminocaproic acid (EACA, an antifibrinolytic lysine analog) was given during mitral valve repair in a patient with no known hypercoagulable condition, set against the complex coagulopathy that follows cardiopulmonary bypass. Its connection to hirudotherapy is conceptual and centers on the hemostatic balance: leech salivary secretome works in the opposite direction, supplying antithrombotic and antiplatelet activity, so this report illustrates the thrombotic risk at the other end of the fibrinolysis spectrum that clinicians weigh when managing surgical bleeding versus clotting. Honest caveat: this is a single, hypothesis-generating case report (the authors themselves pose EACA as a question), it involves no leeches, and it cannot establish that EACA causes such thrombosis, only that the events were temporally associated.