Heparin-induced thrombocytopenia in coronary bypass surgery.
We report on a 51-year-old man with severe two-vessel coronary disease and an ejection fraction of 15% who presented with myocardial ischemia and heparin-induced thrombocytopenia after coronary angioplasty. Before coronary bypass surgery, the antithrombin agent argatroban was used for anticoagulation and an intraaortic balloon pump was inserted. Direct coronary bypass surgery was performed to the left anterior descending artery and to the posterior descending artery using the 'Octopus' tissue stabilization device (Manfrotto, Feltre, Italy). The postoperative course was uneventful and associated with normal platelet counts. The patient was discharged on the 6th postoperative day.
Arnoletti
J P
JP
Department of Surgery, Medical College of Pennsylvania, Hahnemann School of Medicine, Philadelphia 19102, USA. jupablo@pol.net
Whitman
G J
GJ
D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001120:Arginine / Q000031:analogs & derivatives; D001026:Coronary Artery Bypass; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000601:surgery*; D010875:Pipecolic Acids / Q000008:administration & dosage; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D010976:Platelet Count; D012307:Risk Factors; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000601:surgery
D000925:Anticoagulants; D010875:Pipecolic Acids; D010975:Platelet Aggregation Inhibitors; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban