A 49-year-old man with unstable angina and a history of severe anaphylaxis to seafood and intravenous iodine needed myocardial revascularization. Because of concern of an intraoperative protamine reaction, preoperative treatment was instituted with steroids and with H1 and H2 blockers. Revascularization was accomplished using a heparin-coated cardiopulmonary bypass circuit. Complement activation and postoperative bleeding were minimal. Heparin-coated cardiopulmonary bypass is a safe, effective technique of bypass in select patients.
