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Ann Thorac Surg 1999;68:1076-1078
© 1999 The Society of Thoracic Surgeons

Case Reports

Pediatric heparin-induced thrombocytopenia: management with Danaparoid (Orgaran)

Ben R. Saxon, FRACPa, Michael D. Black, MDb, David Edgell, CCPa, Dionne Noel, CCPa, Michael T. Leaker, MDa

a Division of Haematology/Oncology, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
b Division of Cardiac Surgery and Cardiovascular Perfusion, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada

Address reprint requests to Dr Black, Department of Cardiac Surgery, Lucile Packard Children’s Hospital, Stanford University School of Medicine, Stanford, CA 94305-5407
e-mail: michael.black{at}stanford.edu

Heparin-induced thrombocytopenia is a rare and serious complication of anticoagulation therapy. There remains a paucity of information pertaining to alternative anticoagulation strategies for use during cardiopulmonary bypass concomitant with heparin-induced thrombocytopenia, especially in children. We report the successful treatment of heparin-induced thrombocytopenia and subsequent hemorrhagic complications postoperatively in a 2-year-old child with Danaparoid (orgaran). Emergent conduit revision with cardiopulmonary bypass was required for a thrombosed systemic-venous to pulmonary-arterial connection (completion modified Fontan procedure). Required doses of Danaparoid were consistently twofold that previously reported for adults.




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