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Ann Thorac Surg 2003;75:577-579
© 2003 The Society of Thoracic Surgeons
a Institute of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
b Department of Anesthesiology and Critical Care, Heart and Diabetes Center, Mecklenburg/Vorpommern, Karlsburg, Germany
c Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center, Mecklenburg/Vorpommern, Karlsburg, Germany
Accepted for publication August 19, 2002.
* Address reprint requests to Dr Lubenow, Ernst-Moritz-Arndt Universität, Institut für Immunologie und Transfusionsmedizin, Abteilung Transfusionsmedizin, Klinikum, Sauerbruchstrasse, 17489 Greifswald, Germany
e-mail: lubenow{at}uni-greifswald.de
Heparin-induced thrombocytopenia (HIT), a serious complication of heparin therapy, mandates heparin cessation and alternative anticoagulation. We report a patient with a history of HIT who successfully underwent cardiopulmonary bypass (CPB) using short-term reexposure to heparin and perioperative therapy with argatroban. No bleeding complications or HIT-related problems occurred. The pharmacokinetics of argatroban, especially its hepatic rather than renal elimination, makes it the drug of choice for some HIT patients in whom other alternative anticoagulants (eg, danaparoid and hirudin) are less well suited. Because of interference with the international normalized ratio (INR), switching from argatroban to oral anticoagulants is not straightforward.
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