Cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia II and impaired renal function using heparin and the platelet GP IIb/IIIa inhibitor tirofiban as anticoagulant

Ann Thorac Surg. 2000 Dec;70(6):2160-1. doi: 10.1016/s0003-4975(00)01888-9.

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.

Publication types

  • Case Reports

MeSH terms

  • Cardiopulmonary Bypass*
  • Drug Therapy, Combination
  • Female
  • Heart Valve Prosthesis Implantation*
  • Heparin / adverse effects*
  • Heparin / therapeutic use
  • Hirudins / administration & dosage
  • Humans
  • Kidney Function Tests*
  • Middle Aged
  • Mitral Valve / surgery*
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
  • Postoperative Care
  • Prosthesis Failure
  • Recombinant Proteins / administration & dosage
  • Reoperation
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / drug therapy
  • Tirofiban
  • Tyrosine / adverse effects
  • Tyrosine / analogs & derivatives*
  • Tyrosine / therapeutic use*

Substances

  • Hirudins
  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Recombinant Proteins
  • Tyrosine
  • Heparin
  • Tirofiban