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Ann Thorac Surg 1993;55:1555-1557
© 1993 The Society of Thoracic Surgeons

Articles

Perioperative paraplegia and multiorgan failure from heparin-induced thrombocytopenia

William C. Feng, MD, Arun K. Singh, MD*, Arthur A. Bert, MD, Stephen J. Sanofsky, MD, James P. Crowley, MD

Division of Cardiothoracic Surgery and Departments of Anesthesia and Medicine, Rhode Island Hospital and Brown University School of Medicine, Providence, Rhode Island USA

Accepted for publication July 20, 1992.

* Address reprint requests to Dr Singh, Suite 238, 110 Lockwood, Providence, RI 02903.

Heparin-induced thrombocytopenia and thrombosis syndrome is a rare but devastating completion. We report a patient with heparin-induced thrombocytopenia in whom heparin-induced thrombocytopenia and thrombosis syndrome developed after a cardiac operation, complicated by acute thrombosis of the aorta followed by renal failure, paralysis, and ischemic necrosis of the lower extremities. The literature suggests aspirin, dipyridamoie, and iloprost as effective prophylactic agents for perioperative heparin-induced thrombocytopenia and thrombosis syndrome. This unfortunate complication underscores the importance of close platelet count monitoring in all preoperative patients undergoing prolonged heparin therapy.




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