Heparin-induced thrombocytopenia and heart operation: management with tedelparin.
Anticoagulation for cardiopulmonary bypass in the infrequent clinical setting of thrombocytopenia associated with the use of unfractionated heparin is a very serious problem. We describe a case in which a low-molecular-weight heparin (tedelparin) was selected for this purpose based on a platelet aggregation test, permitting adequate anticoagulation during cardiopulmonary bypass for valve replacement. This case report might help establish an adequate anticoagulation protocol when faced with a patient suffering from this condition.
Unitat d'Hemostasia i Trombosi, Servei de Cirurgia Cardíaca, Barcelona, Spain.
A
A
Altés
R
R
Martino
M
M
Gari
M L
ML
Cámara
R
R
Garín
J I
JI
Casas
J
J
Fontcuberta
D002315:Cardiopulmonary Bypass; D017985:Dalteparin / Q000627:therapeutic use*; D005260:Female; D006350:Heart Valve Prosthesis; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis
D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D017985:Dalteparin