Perioperative paraplegia and multiorgan failure from heparin-induced thrombocytopenia.
Heparin-induced thrombocytopenia and thrombosis syndrome is a rare but devastating complication. We report a patient with heparin-induced thrombocytopenia in whom heparin-induced thrombocytopenia and thrombosis syndrome developed after a cardiac operation, complicated by acute thrombosis of the aorta followed by renal failure, paralysis, and ischemic necrosis of the lower extremities. The literature suggests aspirin, dipyridamole, and iloprost as effective prophylactic agents for perioperative heparin-induced thrombocytopenia and thrombosis syndrome. This unfortunate complication underscores the importance of close platelet count monitoring in all preoperative patients undergoing prolonged heparin therapy.
Division of Cardiothoracic Surgery, Rhode Island Hospital, Providence.
W C
WC
Feng
A K
AK
Singh
A A
AA
Bert
S J
SJ
Sanofsky
J P
JP
Crowley
D001012:Aorta, Abdominal; D001026:Coronary Artery Bypass; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology*; D010264:Paraplegia / Q000209:etiology*; D010976:Platelet Count; D011183:Postoperative Complications / Q000209:etiology*; D013577:Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications; D013927:Thrombosis / Q000139:chemically induced* / Q000150:complications
D006493:Heparin