Summary
Mini-dose heparin has demonstrated a significant decrease in postoperative deep venous thrombosis as manifested by 125I fibrinogen venous limb scans. Whether a similar benefit in lethal pulmonary emboli can be demonstrated is currently under active investigation in England and the Continent. If this European multicenter trial yields a positive result, a safe method for the primary prevention of postoperative pulmonary emboli will have been established. Such a result would encourage evaluation of mini-dose heparin for the prophylaxis of venous thromboembolism among patients with acute myocardial infarction and perhaps for arterial thrombosis complicating coronary arterial bypass surgery.
The late Carl V. Moore, when told of the original Kakkar trial and the rationale behind it, said “well, if it doesn’t work, it ought to!” That may be the way many sympathetic investigators, myself included, feel about mini-dose heparin, but in the end everyone knows that the decisions will be based on hard data.
