title: Intraoperative anticoagulation management during cardiac transplantation for a patient with heparin-induced thrombocytopenia and a left ventricular assist device.
abstract: Heparin-induced thrombocytopenia is an immunologically mediated syndrome that is associated with potentially life-threatening arterial and venous thrombosis. Re-exposing patients who have heparin-induced thrombocytopenia to heparin during cardiopulmonary bypass may be hazardous. We describe the re-exposure to unfractionated heparin of a patient with a left ventricular assist device and evidence of heparin-induced thrombocytopenia who needed cardiac transplantation, which was accomplished without complications.
authors.affiliation: Department of Cardiopulmonary Transplantation and the Center for Cardiac Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA. yasminwadia@yahoo.com
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Wadia
authors.forename: John R
authors.initials: JR
authors.lastname: Cooper
authors.forename: Arthur W
authors.initials: AW
authors.lastname: Bracey
authors.forename: Katheleen
authors.initials: K
authors.lastname: Pinto
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D002315:Cardiopulmonary Bypass; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D016027:Heart Transplantation / Q000379:methods*; D006353:Heart-Assist Devices; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006629:Hirudins / Q000008:administration & dosage; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000139:chemically induced
chemical_list: D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D006629:Hirudins; D011994:Recombinant Proteins; C036309:fibrin fragment D; D005340:Fibrinogen; D006493:Heparin; C083544:lepirudin