title: [Rapid Rise of Trans-oxygenerator Pressure Gradient Accompanied by Rapid Decrease of Platelet Counts During Open-heart Surgery].
abstract: A 77-year-old male patient with 2-vessel coronary artery disease and previous myocardial infarction underwent on-pump coronary artery bypass grafting (CABG). Following systemic heparinization, cardiopulmonary bypass using heparin coated circuit was started. Ten minutes after starting the cardiopulmonary bypass, the trans-oxygenerator pressure gradient rapidly increased accompanied by a rapid decrease of platelet counts. Emergency replacement of cardiopulmonary bypass circuit with a non-heparin coated one was performed because the development of heparin induced thrombocytepenia (HIT) was strongly suspected. On-pump CABG was accomplished as planned, and the postoperative course was uneventful. HIT might be ruled out as HIT specific antibodies were not detected in the intraoperative serum samples.
authors.affiliation: Division of Cardiovascular Surgery, National Hospital Organization Kure Medical Center, Kure, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ryugo
authors.forename: Norio
authors.initials: N
authors.lastname: Mouri
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Kurita
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Hara
authors.forename: Masashi
authors.initials: M
authors.lastname: Tagaya
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010976:Platelet Count; D011183:Postoperative Complications
chemical_list: D000925:Anticoagulants; D006493:Heparin