Heparin-induced thrombocytopenia after coronary artery bypass grafting with cardiopulmonary bypass: report of a case.
A 79-year-old man was transferred to our hospital with severe chest pain and a suspected diagnosis of acute myocardial infarction. Emergency cardiac catheterization showed triple-vessel coronary artery disease, and we performed coronary artery bypass grafting under cardiopulmonary bypass (CPB). Continuous hemodiafiltration was started for acute renal failure postoperatively, and heparin was given as an anticoagulanting agent. By 9 days after the initiation of heparin therapy, his platelet count had fallen and a deep vein thrombosis had formed in his left leg. We suspected heparin-induced thrombocytopenia (HIT), and immediately discontinued the heparin, implementing danaparoid (Orgaran) instead, following which the platelet count recovered. Heparin-induced thrombocytopenia, which causes thrombosis, is a serious side effect of heparin therapy and few cases of HIT associated with CPB surgery have been reported in Japan.
Ishida
Keiichi
K
Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
Imamaki
Mizuho
M
Ishida
Atsushi
A
Shimura
Hitoshi
H
Miyazaki
Masaru
M
D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy; D000368:Aged; D006328:Cardiac Catheterization; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000601:surgery*; D018450:Disease Progression; D017809:Fatal Outcome; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D011300:Preoperative Care / Q000379:methods; D006435:Renal Dialysis; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
D006493:Heparin