IJCS | Volume 33, Nº3, May / June 2020

data were also collected. The study outcomes were: bleeding, thrombocytopenia, postoperative vasoplegia, activated clotting time shorter than 400 seconds and coagulation phenomena, such as blood clotting with bovine UFH (data on porcine UFH were also collected only as exploratory means). Torres et al., 7 evaluated 204 medical records of eligible patients who used bovine UFH. Out of these patients, 66.18% presented thrombocytopenia, whereas 1.04% presented bleeding of more than 2000 mL, within the first 24 hours of the postoperative period. Only one patient presented clots in the surgical field. Median activated clotting time increased five-fold after the first dose of heparin and, after protamine, it returned to similar baseline values. Basedon these findings, the authors have concluded that bovine UFH does not present unusual adverse effects and can be considered safe for on-pump cardiac surgery. Gomes et al., 8 have also published a paper on a preliminary study evaluating the safety and important clinical aspects of bovine UFH use in heart surgery and compared it to porcine heparin, both obtained from intestinal mucosa. Data were extracted from medical records as well. The main finding of this work was in accordance to Torres et al 7 , as similar data were obtained from bovine and porcine UFH treated patients. They have evaluated bleeding volume, modulation of clotting, presence of clot in the surgical field during ECC, activated partial thromboplastin time and specific anti-Xa anticoagulant activity. The authors concluded that bovine UFH may be the solution for the tainted heparin supply. Although the paper presented by Torres et al., 7 has limitations consistent with retrospective studies, it is an important contribution to the field. The use of bovine UFH is on the rise due to contamination of porcine UFH with oversulfated chondroitin sulfate, which has caused serious adverse effects. Therefore, studies that corroborate the safety of bovine UFH are welcome. 1. Kreuziger LB, Karkouti K, Tweddel J, Massicotte MP. Antithrombotic therapy management of adult and pediatric cardiac surgery patients. J Thromb Haemost. 2018;16(11):2133-46. 2. Feindt P, Benk C, Boeken U, Bauer A, Mehlhorn U, Gehron J, et al. Use of extracorporeal circulation (ECC) outside the cardiac operating room: indications, requirements and recommendations for routine practice. Thorac Cardiovasc Surg. 2011;59(2):66-8. 3. Lukaszewski M, Kosiorowska K, Kościelska‑Kasprzak K, Jakubaszko J, Bielicki G, Jasiński M. The use of modern monitoring techniques and methodologies in conducting extracorporeal circulation: a place for Quantum Heart Lung Machine. Kardiol Pol. 2019;77(6):642-4. 4. Torrati FG, Dantas RAS. Extracorporeal circulation and complications during the immediate postoperative period for cardiac surgery. Acta Paul Enferm. 2012; 25(3):340-5. 5. Devlin A, Mycroft-West C, Procter P, Cooper L, Guimond S, Lima M, et al. Tools for the quality control of pharmaceutical heparin. Medicina. 2019; 55(10):1-19. 6. Kouta A, Jeske W, Hoppensteadt D, Iqbal O, Yao Y, Fareed J. Comparative pharmacological profiles of various bovine, ovine, and porcine heparins. Clin Appl Thromb Haemost. 2019;25:1-9. 7. Torres FAL, Torres ACB, Ribeiro A, Maia CO, Almeida FP, Roceto J, et al. A Retrospective Study on Unfractionated Bovine Heparin Safety in On-Pump Cardiac Surgery. Int J Cardiovasc Sci. 2020; 33(3):235-242. 8. Gomes WJ, Leal JC, Braile DM, Guimarães JA, Lopes RD, Lima MA, et al. A Brazilian perspective for the use of bovine heparin in open heart surgery. Int J Cardiol. 2016;15(223):611-2. References 244 Martins & Scaramello Bovine heparin and therapeutic safety Int J Cardiovasc Sci. 2020; 33(3):243-244 Editorial This is an open-access article distributed under the terms of the Creative Commons Attribution License