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Ann Thorac Surg 2001;71:1041-1042
© 2001 The Society of Thoracic Surgeons
a Departments of Anesthesiology and Critical Care, Heart and Diabetes Centre Mecklenburg-Vorpommern, Karlsburg, Germany
b Departments of Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre Mecklenburg-Vorpommern, Karlsburg, Germany
c Department of Transfusion Medicine, Institute of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
Accepted for publication September 19, 2000.
Address reprint requests to Dr Greinacher, Ernst-Moritz-Arndt Universität, Institut für Immunologie und Transfusionsmedizin, Klinikum/Sauerbruchstrasse, 17489 Greifswald, Germany
We present a case of emergency coronary artery bypass surgery in a bilaterally nephrectomized patient with a history of heparin-induced thrombocytopenia. The patient was reexposed short term to heparin during cardiopulmonary bypass and did not develop any complications related to heparin-induced thrombocytopenia. Despite intraoperative neutralization of heparin severe bleeding complications occurred, probably resulting from preoperative therapeutic anticoagulation with r-hirudin in conjunction with an increased half-life of more than 2 days.
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