Heparin-induced thrombocytopenia and cardiopulmonary bypass: anticoagulation with unfractionated heparin and the GPIIb/IIIa inhibitor tirofiban and successful use of rFVIIa for post-protamine bleeding due to persistent platelet blockade
Heparin-induced thrombocytopenia was diagnosed in a 50-year-old man on day 5 after cardiac surgery (aorto-coronary bypass and mitral valve replacement). He required redo (para-prosthesis leak) on day 13. The cardiopulmonary bypass (CPB) was performed with unfractionated heparin (UFH) and the platele...
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Published in | European journal of cardio-thoracic surgery Vol. 34; no. 3; pp. 687 - 689 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Amsterdam
Elsevier Science B.V
01.09.2008
Elsevier Science |
Subjects | |
Online Access | Get full text |
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Summary: | Heparin-induced thrombocytopenia was diagnosed in a 50-year-old man on day 5 after cardiac surgery (aorto-coronary bypass and mitral valve replacement). He required redo (para-prosthesis leak) on day 13. The cardiopulmonary bypass (CPB) was performed with unfractionated heparin (UFH) and the platelet glycoprotein (GP) IIb/IIIa inhibitor tirofiban. Post-protamine bleeding likely due to documented persistent platelet blockade by tirofiban was successfully treated with one dose of recombinant activated factor VII (rFVIIa, 60 μg/kg). No thrombotic complications were detected. The management of CPB with UHF and tirofiban is a convenient option and rFVIIa seems appropriate to handle bleeding issues. |
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Bibliography: | ark:/67375/HXZ-G2TVPWGP-B istex:526DF3ED7CF746CDBB37F84ACB7FEE81ED7B5A87 Corresponding author. Address: CHU Nancy, Service de Chirurgie Cardio-Vasculaire, Nancy, France. Tel.: +33 6 10 57 96 21; fax: +33 3 83 08 44 08. |
ISSN: | 1010-7940 1873-734X |
DOI: | 10.1016/j.ejcts.2008.05.029 |