JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
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Original Article
Should postoperative ACT in cardiac surgery be high or low?
Abstract
Aims: The aim of this study was to compare the activated clotting time (ACT) values after heparin neutralization with the values before heparin in patients undergoing cardiac surgery and to investigate the relationship with postoperative outcomes.
Methods: Between 2022 and 2023, 726 patients (518 males; mean age 58.2±11.5 years) who underwent cardiac surgery were evaluated. The patients were first divided into two groups. Group A (n=401): Patients whose ACT values before heparinization were lower than the ACT values after neutralization and Group B (n=325): Patients whose ACT values before heparinization were equal to or higher than the ACT values after neutralization.
Results: There was no difference between the groups regarding bleeding amount and blood product use. The need for postoperative exploration and subxiphoid decompression was higher in Group B than in Group A (p=0.001, and p=0.008, respectively). There was no difference between the groups in terms of hospital stay. The intubation time and intensive care unit stay were longer in Group B than in Group A (p=0.003, and p=0.04, respectively). The mortality rate was higher in Group B than in Group A (p=0.02).
Conclusion: In cardiac surgery, we found no difference in bleeding amounts and blood product use in patients with post-neutralization ACT values higher than pre-heparin ACT values compared to patients with lower ACT values. However, we found higher postoperative exploration and mortality rates and longer intubation times. Keywords: Activated clotting time, heparin, protamine sulfate, cardiac surgery, bleeding

Keywords : Activated clotting time, heparin, protamine sulfate, cardiac surgery, bleeding

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Article available in :
Volume 4, Issue 1, 2026
Page : 14-20
https://doi.org/10.51271/JCCVS-0070
Article Information
Received : 09 Şub 2026
Accepted : 26 Mar 2026
Published : 28 Mar 2026
Corresponding Author :

Osman Fehmi Beyazal: Basaksehir Cam and Sakura City Hospital

[email protected]
Citation : Beyazal OF, Yanartaş M. Should the postoperative ACT value be higher or lower than the preoperative value in cardiac surgery? J Cardiol Cardiovasc Surg. 2026;4(1):14-20. doi:10.51271/JCCVS-0070

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