[Oxygenator thrombosis without heparin resistance in polycythemia vera].
A 55-year-old male with a history of positive HIV serology and polycythemia vera underwent coronary artery bypass graft surgery with normothermic extracorporeal circulation. Following heparin administration the activated clotting time (ACT) was 633 seconds (Hemocron with kaolin). Lower than expected arterial and venous oxygen partial pressures together with high pressure (350 mmHg) in the arterial line upstream of the oxygenator were observed. Because of these signs the oxygenator was changed during the procedure. The outcome was uneventful. Electronic microscopic examination of the oxygenator membrane and thermic exchanger revealed fibrin and platelet deposits. Similar cases are described in the literature during polycythemia vera. Therefore the prevention might be a preoperative treatment with antiplatelet therapy in polycytemia vera.
Service d'anesthésie-réanimation, Hospices Civils de Lyon, Hôpital Louis-Pradel, BP Lyon Montchat, 69394 Lyon cedex 3, France. jean- jacques.lehot@chu- lyon.fr
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D000925:Anticoagulants / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010107:Oxygenators, Membrane / Q000009:adverse effects*; D011087:Polycythemia Vera / Q000150:complications*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology*
D000925:Anticoagulants; D006493:Heparin