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Ann Thorac Surg 2000;70:2160-2161
© 2000 The Society of Thoracic Surgeons

Case report

Cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia II and impaired renal function using heparin and the platelet GP IIb/IIIa inhibitor tirofiban as anticoagulant

Andreas Koster, MDa, Matthias Loebe, MDb, Fritz Mertzlufft, MDb, Hermann Kuppe, MDa, Roland Hetzer, MDb

a Department of Anesthesia, Deutsches Herzzentrum Berlin, Berlin, Germany
b Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany

Accepted for publication May 14, 2000.

Address reprint requests to Dr Koster, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13305 Berlin
e-mail: koster{at}dhzb.de

In a patient with heparin-induced thrombocytopenia II and impaired renal function, anticoagulation during cardiopulmonary bypass was successfully performed by the use of unfractionated heparin and the platelet glycoprotein IIb/IIIa inhibitor tirofiban. Postoperative antithrombotic therapy with recombinant hirudin was immediately initiated. This regimen for anticoagulation for cardiopulmonary bypass in patients with heparin-induced thrombocytopenia II appears to be particularly appropriate for patients with impaired renal function or for hospitals without special experience with other alternative anticoagulation strategies.




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