Multiple thromboses, including intracardiac thrombi, accompanied by HIT during ECMO successfully treated with NOACs: A case report

Won-Sik Yun; Sanghyo Kim; Lae-Young Jung

doi:10.1177/02676591241227903

Multiple thromboses, including intracardiac thrombi, accompanied by HIT during ECMO successfully treated with NOACs: A case report

Perfusion. 2024 Jan 18:2676591241227903. doi: 10.1177/02676591241227903. Online ahead of print.

Authors

Won-Sik Yun¹, Sanghyo Kim¹, Lae-Young Jung^{1

2

3}

Affiliations

¹ Division of Cardiology, Hospital and Jeonbuk National University Medical School, Jeonbuk National University, Jeonju, Korea.
² Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju, Korea.
³ Biomedical Research Institute, Jeonbuk National University, Jeonju, Korea.

PMID: 38239000
DOI: 10.1177/02676591241227903

Abstract

Introduction: Unfractionated heparin remains the mainstay of anticoagulation therapy during extracorporeal membrane oxygenation (ECMO) maintenance. However, its continued use in clinical practice exposes patients to the risk of developing heparin-induced thrombocytopenia (HIT).

Case report: A 50-year-old male was diagnosed with multiple thromboses, including an intracardiac thrombi, accompanied by HIT during ECMO after cardiogenic shock related to acute myocardial infarction. The patient was successfully treated with new oral anticoagulants (NOAC), without significant complications.

Discussion: HIT during ECMO resulting in multiple thromboses is rare. To our knowledge, this is the first reported case of NOAC use in this context.

Conclusion: Although thrombocytopenia and thrombosis can occur for various reasons during ECMO maintenance, it is important to consider HIT as a potential cause. NOACs can be considered as a therapeutic option.

Keywords: extra-corporeal membrane oxygenation; heparin induced thrombocytopenia; new oral anticoagulants (NOACs).