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Carol L. Lake, MD; William P. Arnold, MD; Robert M. Epstein, MD
University of Virginia Medical Center Charlottesville

JAMA. 1985;253(12):1723.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

In their excellent retrospective study of 10,590 men for diseases or conditions related to vasectomy by an immunopathological mechanism, Massey and colleagues¹ discuss potential cardiovascular complications of the procedure in detail. These authors indicate an absence of adverse cardiovascular effects of vasectomy. However, they do not mention the possibility of adverse reactions in these patients during subsequent diagnostic or therapeutic interventions in which anticoagulation and its antagonism with protamine are used. Watson and coworkers² recently described an anaphylactoid reaction immediately following the administration of protamine to a vasectomized patient undergoing cardiac catheterization and coronary angiography. Pretreatment with steroids and antihistamines prevented another episode when protamine was administered during aortocoronary bypass surgery.² With increased use of vasectomy for birth control, and of coronary angiography, percutaneous transluminal angioplasty, and aortocoronary bypass grafting for coronary artery disease, the likelihood of hemodynamically significant responses to protamine merits heightened awareness . . . [Full Text PDF of this Article]

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