Intraoperative infusion of epoprostenol sodium for patients with heparin-induced thrombocytopenia undergoing cardiac surgery.
Prevention of catastrophic thromboembolic complications during surgery in patients with heparin-induced thrombocytopenia (HIT) remains a challenging problem during cardiac surgery. We infused an increasing dose of epoprostenol sodium, which is one of three anti-HIT regimens available in Japan, ahead of administration of heparin and performed a mitral valve operation for a patient with type II HIT. The absence of thromboembolic events and platelet consumption during cardiopulmonary bypass, together with considerable reduction of platelet adhesion to the fibers of the membrane oxygenator, support the efficacy and safety of our strategy.
Yamamoto
Keisuke
K
Department of Thoracic and Cardiovascular Surgery, Kagoshima Graduate School of Medical and Dental Sciences, Japan. keisukeman28@hotmail.com
Sakata
Ryuzo
R
Iguro
Yoshifumi
Y
Ueno
Tetsuya
T
Ueno
Masahiro
M
Ueno
Takayuki
T
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001282:Atrial Flutter / Q000209:etiology / Q000601:surgery; D006348:Cardiac Surgical Procedures; D011464:Epoprostenol / Q000008:administration & dosage / Q000627:therapeutic use*; D006333:Heart Failure / Q000209:etiology / Q000601:surgery; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D008297:Male; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000188:drug therapy*; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000601:surgery
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D011464:Epoprostenol