title: Lepirudin as an alternative to "heparin allergy" during cardiopulmonary bypass.
abstract: A treatment strategy of a difficult and unusual problem is presented. We are reporting a case of a patient who had a documented allergy to heparin and required Cardiac surgery for an ASD closure. The anticoagulation regime used during cardiopulmonary bypass was lepirudin based. This report indicates that r-hirudin provides effective anticoagulation, however unless ECT is monitoring, post operative hemorrhage is encountered. Therefore this case is unique not only because of its rarity but also by the fact that it presents the caveats encountered when ECT is not available.
authors.affiliation: Cardiothoracic Dept, Royal Victoria Hospital, Grosvernor Rd, Belfast, BT12 6BA, Northern Ireland. hparissis@yahoo.co.uk
authors.forename: Haralabos
authors.initials: H
authors.lastname: Parissis
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006493:Heparin / Q000009:adverse effects*; D006629:Hirudins; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011994:Recombinant Proteins / Q000627:therapeutic use; D013927:Thrombosis / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin