EJCTS Click here for details of sales representative
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Eur J Cardiothorac Surg 2008;34:687-689. doi:10.1016/j.ejcts.2008.05.029
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Durand, M.
Right arrow Articles by Carteaux, J.-P.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Durand, M.
Right arrow Articles by Carteaux, J.-P.
Related Collections
Right arrow Cardiac - pharmacology
Right arrow Extracorporeal circulation

Case reports

Heparin-induced thrombocytopenia and cardiopulmonary bypass: anticoagulation with unfractionated heparin and the GPIIb/IIIa inhibitor tirofiban and successful use of rFVIIa for post-protamine bleeding due to persistent platelet blockade

Marion Duranda,b,c,*, Thomas Lecomptea,b,d, Marie Hacquarda,b,d, Jean-Pierre Carteauxa,b,c

a Inserm, U 734, Vandoeuvre-les-Nancy, France
b Nancy-Université Université Henri Poincaré, Nancy, France
c CHU Nancy, Service de Chirurgie Cardio-Vasculaire, Nancy, France
d CHU Nancy, Service d’Hématologie Biologique, Nancy, France

Received 24 September 2007; received in revised form 25 March 2008; accepted 19 May 2008.

* Corresponding author. Address: CHU Nancy, Service de Chirurgie Cardio-Vasculaire, Nancy, France. Tel.: +33 6 10 57 96 21; fax: +33 3 83 08 44 08. (Email: durandmarion{at}hotmail.com).

Heparin-induced thrombocytopenia was diagnosed in a 50-year-old man on day 5 after cardiac surgery (aorto-coronary bypass and mitral valve replacement). He required redo (para-prosthesis leak) on day 13. The cardiopulmonary bypass (CPB) was performed with unfractionated heparin (UFH) and the platelet glycoprotein (GP) IIb/IIIa inhibitor tirofiban. Post-protamine bleeding likely due to documented persistent platelet blockade by tirofiban was successfully treated with one dose of recombinant activated factor VII (rFVIIa, 60 µg/kg). No thrombotic complications were detected. The management of CPB with UHF and tirofiban is a convenient option and rFVIIa seems appropriate to handle bleeding issues.

Key Words: Heparin-induced thrombocytopenia • Cardiopulmonary bypass • Unfractionated heparin • Tirofiban • rFVIIa






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.