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Ann Thorac Surg 1989;48:712-713
© 1989 The Society of Thoracic Surgeons

Articles

Ancrod anticoagulation for cardiopulmonary bypass in heparin-induced thrombocytopenia and thrombosis

S.J. Teasdale, MD*, V.J. Zulys, MD, T. Mycyk, MD, R.J. Baird, MD, M.F.X. Giynn, MD

Departments of Anaesthesia, Cardiovascular Surgery, and Hematology, Toronto General Hospital, University of Toronto, Ontario, Canada

Accepted for publication March 30, 1989.

* Address reprint requests to Dr Teasdale, Department of Anaesthesia, Toronto General Hospital, 200 Elizabeth St, Toronto, Ont, M5G IL7 Canada.

Hepatin-induced thrombocytopenia and thrombosis was diagnosed in a 50-year-old man undergoing a repeat heart operation after heparinization led to microemboli and an eventual left transmetatarsal amputation. A third heart operation was aborted when anticoagulation with low molecular weight heparin produced intraoperative thrombi. The patient was referred to Toronto where ancrod (Arvin) was used to lower plasma fibrinogen level, allowing successful repair of a ventricular septal defect using cardiopulmonary bypass support. The patient made an uneventful recovery.




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