Abstract
In a patient with heparin-induced thrombocytopenia II and impaired renal function, anticoagulation during cardiopulmonary bypass was successfully performed by the use of unfractionated heparin and the platelet glycoprotein IIb/IIIa inhibitor tirofiban. Postoperative antithrombotic therapy with recombinant hirudin was immediately initiated. This regimen for anticoagulation for cardiopulmonary bypass in patients with heparin-induced thrombocytopenia II appears to be particularly appropriate for patients with impaired renal function or for hospitals without special experience with other alternative anticoagulation strategies.
MeSH terms
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Cardiopulmonary Bypass*
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Drug Therapy, Combination
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Female
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Heart Valve Prosthesis Implantation*
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Heparin / adverse effects*
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Heparin / therapeutic use
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Hirudins / administration & dosage
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Humans
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Kidney Function Tests*
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Middle Aged
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Mitral Valve / surgery*
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Platelet Aggregation Inhibitors / adverse effects
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Platelet Aggregation Inhibitors / therapeutic use*
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Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
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Postoperative Care
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Prosthesis Failure
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Recombinant Proteins / administration & dosage
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Reoperation
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Thrombocytopenia / chemically induced*
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Thrombocytopenia / drug therapy
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Tirofiban
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Tyrosine / adverse effects
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Tyrosine / analogs & derivatives*
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Tyrosine / therapeutic use*
Substances
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Hirudins
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Platelet Aggregation Inhibitors
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Platelet Glycoprotein GPIIb-IIIa Complex
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Recombinant Proteins
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Tyrosine
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Heparin
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Tirofiban