Cardiopulmonary bypass with danaparoid sodium and ancrod in heparin-induced thrombocytopenia.
Heparin is the standard anticoagulant for patients undergoing cardiopulmonary bypass. There are some patients for whom heparin is unsuitable and ancrod (a defibrinogenating enzyme) has been used as an alternative. We present a patient with heparin-induced thrombocytopenia in whom treatment ancrod was ineffective. The addition of danaparoid sodium (a heparinoid) allowed safe cardiopulmonary bypass. We discuss the reasons for this and suggest that the combination of ancrod and danaparoid sodium is a logical one in such cases.
Kanagasabay
R R
RR
Department of Cardiothoracic Surgery, St George's Hospital, London, England. rkanaga@sghms.ac.uk
Unsworth-White
M J
MJ
Robinson
G
G
Bevan
D
D
Farnsworth
G
G
Haxby
E J
EJ
Smith
E E
EE
D000721:Ancrod / Q000008:administration & dosage*; D000925:Anticoagulants / Q000008:administration & dosage*; D001024:Aortic Valve Stenosis / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002809:Chondroitin Sulfates / Q000008:administration & dosage*; D003327:Coronary Disease / Q000601:surgery; D003871:Dermatan Sulfate / Q000008:administration & dosage*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006496:Heparinoids / Q000008:administration & dosage*; D006497:Heparan Sulfate / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications
D000721:Ancrod; D000925:Anticoagulants; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D004338:Drug Combinations; D006493:Heparin; D006496:Heparinoids; D006497:Heparan Sulfate; C035838:danaparoid