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Ann Thorac Surg 1995;59:508-509
© 1995 The Society of Thoracic Surgeons

Articles

Heparin-induced thrombocytopenia and heart operation: Management with tedelparin

MD Albert Altés, MD Rodrigo Martino, Mercè Gari, MD Maria Lluisa Cámara, Rosa Garín, MD Juan-Ignacio Casas, PhD Jordi Fontcuberta*

Unitat d'Hemostasia i Trombosi, Servei de Cirurgia Cardíaca, Servei d'Anestèsia i Reanimacio, Hospital de Sant Pau, Barcelona, Spain

Accepted for publication May 26, 1994.

* Address reprint requests to Dr Fontcuberta, Departament d'Hematologia, Unitat d'Hemostasia i Trombosi, Hospital de Sant Pau, Avda. SAM Claret, 167, 08025, Barcelona, Spain.

Anticoagulation for cardiopulmonary bypass in the infrequent clinical setting of thrombocytopenia associated with the use of unfractionated heparin is a very serious problem. We describe a case in which a low-molecular-weight heparin (tedelparin) was selected for this purpose based on a platelet aggregation test, permitting adequate anticoagulation during cardiopulmonary bypass for valve replacement. This case report might help establish an adequate anticoagulation protocol when faced with a patient suffering from this condition.




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