Its a retrospective study which are interesting for further study but thats about it. I don't know the journal per se as to the quality of the manuscripts. This to me seems like case where the literature doesn't seem to mimic the general clinical experience. I will ask several cardiac anesthetistsfor there opinion if you like.
The amount of protamine used in CV surgery is very small compared to its overall use. Dialysis , cardiac and peripheral angiography, non-cardiac vascular surgery. I doubt with bundled dialysis payments there will be much incentive to spend $$ on heparin reversal.
The half life of heparin is about 45 minutes so generally you wait an hour and the problem takes care of it self without the use of protamine.