Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Use of Desirudin Versus Heparin for Thrombosis Prophylaxis in Cardiothoracic Surgery Patients
Brief Summary: A blood clot in the veins, also known as deep venous thrombosis (DVT), is one of the most common complications after surgery. This may result in death if a clot breaks off and travel to the lungs; this is referred to as pulmonary embolism (PE). After heart surgery the incidence of DVT ranges from 20-48% and following lung surgery the incidence is 19-26%. In order to decrease the likelihood of this complication, patients receive by injection a blood thinning medicine. Heparin is the usual medicine used for this purpose following heart and lung surgery. Recently there have been reports that other medicines may be more effective than heparin for this purpose. Also there have been reports that some patients develop antibodies to heparin. When this occurs, this may prevent the heparin from being effective and may even promote the formation of blood clots. Antibodies to heparin may be present more often following heart and lung surgery than other types of surgery. There is a new medicine called desirudin (Iprivask), which may be used instead of heparin to prevent blood clots following heart and lung surgery. Desirudin is currently approved by the FDA to prevent blood clots following hip surgery. The purpose of this study is to compare desirudin with heparin for the prevention of vein clots after heart and lung surgery.


Options:
A: Inclusion Criteria:

* Male or female
* At least 18 years of age
* Subject needed elective cardiac surgery with cardiopulmonary bypass except for heart transplantation
* Subject had a baseline ATIII level of less than 100% and equal to or above 60%
* Subject signed the informed consent form
* Subject was willing to comply with all aspects of the protocol, including blood sampling, for the total duration of the study

Exclusion Criteria:

* Documented congenital ATIII deficiency or ATIII levels below 60%
* Subject had a baseline ATIII level of 100% or higher
* Subject needed emergency (non-elective) surgery
* Subject needed heart transplantation
* History of anaphylactic reaction(s) to blood or blood components
* Allergies to excipients
* Subject was pregnant
* Subject had any medical condition that according to the investigators judgment worsens the surgical outcome above the expected
* Subject had any medical condition which is likely to interfere with the evaluation of the study treatment and/or the satisfactory conduct of the trial according to the investigators judgment
* Subject had participated in any another investigational study within the last 30 days previous to the inclusion
B: Inclusion Criteria:

* Patients who are scheduled for elective Cardiac or Thoracic Surgery.
* Age \> 18 years of age.

Exclusion Criteria:

* Patients with a clinical suspicion or a documented history of DVT/PE
* Patients who may require anticoagulation during the post-op period. (i.e. Patients with a history of A-fib, scheduled for a MAZE procedure or placement of a mechanical valve, or those on Coumadin/IV heparin preoperatively)
* Patients who have a history of HIT or if there is a suspicion of the patient having HIT pre-operatively.
* Documented allergy to heparin, desirudin, or lepirudin
* Patients with a history of coagulation disorder
* Platelet count\< 100 X109 /dl
* Active bleeding
* Serum Creatinine ≥ 1.5 mg/dl or CrCl ≤ 30 ml/min
* Patients with a baseline coagulopathy (INR \> 1.5 or aPTT \> 45 sec)
* Patients with liver disease
* Pregnancy
* Patients who require ventricular assist devices before or after surgery
C: Inclusion Criteria:

* age at least 18 years
* undergoing first ever multivessel CABG-only surgery with at least 2 free grafts (e.g. Radial artery, saphenous vein, free internal mammary artery)
* undergoing CABG with cardiopulmonary bypass

Exclusion Criteria:

* clear indication for anticoagulation (e.g. prosthetic heart valve replacement, recurrent DVT)
* allergy or intolerance of fondaparinux or unfractionated heparin
* renal failure or other contraindication for coronary artery graft CT angiogram
* inability to provide informed consent
D: Inclusion Criteria:

1. Patient is scheduled to have a Fontan or modified Fontan procedure

Exclusion Criteria:

1. Requirement for long-term anticoagulation (e.g., prosthetic heart valve, active DVT)
2. Risk of significant bleeding or any other known medical contraindication to Heparin, Warfarin, or ASA.
3. Inability to supervise therapy due to social or geographical reasons.
4. Pregnancy or potential pregnancy during study period

Answer: B