title: Non-recovery of ACT in a patient with heparin-induced thrombocytopenia type II during mitral valve replacement using argatroban anticoagulation.
abstract: Argatroban was used as the anticoagulant during cardiopulmonary bypass (CPB) in a patient with heparin-induced thrombocytopenia (HIT) type II undergoing mitral valve replacement. Dosage was reduced because of preoperative congestive liver disorder. Perioperative coagulability was poor, and, ultimately, failure of hemostasis led to a fatal outcome. Although argatroban use as an anticoagulant for HIT is reported, the optimal dose has not been established. During long-term CPB, increasing the total dosage may extend anticoagulant ability, leading to dose dependence. Because no antagonist for argatroban exists, failure of hemostasis might occur.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan, e6580@cc.saga-u.ac.jp.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Tanigawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yamada
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Akira
authors.initials: A
authors.lastname: Nakagawachi
authors.forename: Arisu
authors.initials: A
authors.lastname: Torikai
authors.forename: Yoshirou
authors.initials: Y
authors.lastname: Sakaguchi
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001120:Arginine / Q000031:analogs & derivatives; D001777:Blood Coagulation / Q000187:drug effects; D002315:Cardiopulmonary Bypass / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D010875:Pipecolic Acids / Q000627:therapeutic use*; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014914:Whole Blood Coagulation Time / Q000379:methods
chemical_list: D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban