Heparin Anticoagulation during Cardiopulmonary Bypass in an Antithrombin-III Deficient Patient: Implications Relative to the Etiology of Heparin Rebound

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Abstract
A case of antithrombin-III (AT-III) deficiency was diagnosed on the basis of a diminished anticoagulant effect followirig the administration of heparin for cardiopulmonary bypass. The clinical evaluation and interpretation of a diminished response to heparin is discussed, as are considerations relative to the treatment of AT-III deficient persons whose disorder is not manifest until they are already anesthetized for cardiovascular bypass. The implications of AT-III deficiency relative to the mechanism of heparin rebound are also discussed.