Non-recovery of ACT in a patient with heparin-induced thrombocytopenia type II during mitral valve replacement using argatroban anticoagulation

Argatroban was used as the anticoagulant during cardiopulmonary bypass (CPB) in a patient with heparin-induced thrombocytopenia (HIT) type II undergoing mitral valve replacement. Dosage was reduced because of preoperative congestive liver disorder. Perioperative coagulability was poor, and, ultimate...

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Bibliographic Details
Published in:Journal of anesthesia 2013-12, Vol.27 (6), p.951
Main Authors: Tanigawa, Yoshinori, Yamada, Tomoko, Matsumoto, Koichi, Nakagawachi, Akira, Torikai, Arisu, Sakaguchi, Yoshirou
Format: Article
Language:English
Subjects:
Argatroban
Care and treatment
Case studies
Complications and side effects
Coronary artery bypass
Diagnosis
Health aspects
Risk factors
Thrombocytopenia
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Summary:Argatroban was used as the anticoagulant during cardiopulmonary bypass (CPB) in a patient with heparin-induced thrombocytopenia (HIT) type II undergoing mitral valve replacement. Dosage was reduced because of preoperative congestive liver disorder. Perioperative coagulability was poor, and, ultimately, failure of hemostasis led to a fatal outcome. Although argatroban use as an anticoagulant for HIT is reported, the optimal dose has not been established. During long-term CPB, increasing the total dosage may extend anticoagulant ability, leading to dose dependence. Because no antagonist for argatroban exists, failure of hemostasis might occur.
ISSN:0913-8668
DOI:10.1007/s00540-013-1629-l