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Cardiopulmonary Bypass Surgery in a Patient with Unexpected Heparin-Induced Thrombocytopenia

We report a case of a 77-year-old woman with massive pulmonary embolism associated with heparin-induced thrombocytopenia. Before developing a pulmonary embolism, the patient underwent gastrectomy due to gastric cancer and received subcutaneous heparin calcium for deep venous thrombosis prophylaxis f...

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Detalles Bibliográficos
Autores principales: Miyagawa, Atsushi, Yuri, Koichi, Nakano, Mitsunori, Shinoda, Daigo, Makino, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816026/
https://www.ncbi.nlm.nih.gov/pubmed/36644263
http://dx.doi.org/10.3400/avd.cr.22-00082
Descripción
Sumario:We report a case of a 77-year-old woman with massive pulmonary embolism associated with heparin-induced thrombocytopenia. Before developing a pulmonary embolism, the patient underwent gastrectomy due to gastric cancer and received subcutaneous heparin calcium for deep venous thrombosis prophylaxis for 5 d. Then, thrombectomy with cardiopulmonary bypass using full heparinization was successfully performed. The patient was definitively diagnosed with this condition postoperatively, based on elevated serum antibody levels, in addition to pre- and postoperative thrombocytopenia and thrombosis. Intravenous heparin therapy was switched to argatroban. Although it is uncommon, clinicians should consider this condition in patients with a history of heparin exposure.