Emergency cardiopulmonary bypass in a bilaterally nephrectomized patient with a history of heparin-induced thrombocytopenia: successful reexposure to heparin.
We present a case of emergency coronary artery bypass surgery in a bilaterally nephrectomized patient with a history of heparin-induced thrombocytopenia. The patient was reexposed short term to heparin during cardiopulmonary bypass and did not develop any complications related to heparin-induced thrombocytopenia. Despite intraoperative neutralization of heparin severe bleeding complications occurred, probably resulting from preoperative therapeutic anticoagulation with rhirudin in conjunction with an increased half-life of more than 2 days.
Selleng
S
S
Department of Anesthesiology and Critical Care, Heart and Diabetes Centre Mecklenburg-Vorpommern, Karlsburg, Germany.
Lubenow
N
N
Wollert
H G
HG
Müllejans
B
B
Greinacher
A
A
D000925:Anticoagulants / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass; D004630:Emergencies; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012074:Remission Induction; D013921:Thrombocytopenia / Q000139:chemically induced*
D000925:Anticoagulants; D006493:Heparin