title: Ancrod anticoagulation for cardiopulmonary bypass in heparin-induced thrombocytopenia and thrombosis.
abstract: Heparin-induced thrombocytopenia and thrombosis was diagnosed in a 50-year-old man undergoing a repeat heart operation after heparinization led to microemboli and an eventual left transmetatarsal amputation. A third heart operation was aborted when anticoagulation with low molecular weight heparin produced intraoperative thrombi. The patient was referred to Toronto where ancrod (Arvin) was used to lower plasma fibrinogen level, allowing successful repair of a ventricular septal defect using cardiopulmonary bypass support. The patient made an uneventful recovery.
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Ontario, Canada.
authors.forename: S J
authors.initials: SJ
authors.lastname: Teasdale
authors.forename: V J
authors.initials: VJ
authors.lastname: Zulys
authors.forename: T
authors.initials: T
authors.lastname: Mycyk
authors.forename: R J
authors.initials: RJ
authors.lastname: Baird
authors.forename: M F
authors.initials: MF
authors.lastname: Glynn
mesh_terms: D000721:Ancrod / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced / Q000517:prevention & control*; D013927:Thrombosis / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D006493:Heparin; D000721:Ancrod