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Ann Thorac Surg 2003;76:615-617
© 2003 The Society of Thoracic Surgeons

Case report

Off-pump right atrial thrombectomy for heparin-induced thrombocytopenia with thrombosis

Jeffrey A. Morgan, MDa*, Aftab R. Kherani, MDa, Deon W. Vigilance, MDa, Faisal H. Cheema, MDa, Nicholas J. Colletti, BSa, David I. Sahar, MDb, Kung-Ming Jan, MD, PhDb, David L. Diuguid, MDb, Roman Nowygrod, MDc, Mehmet C. Oz, MDa, Michael Argenziano, MDa

a Division of Cardiothoracic Surgery, New York, NY, USA
b Department of Medicine, New York, NY USA
c and Division of Vascular Surgery, College of Physicians and Surgeons, Columbia University, New York, New York, USA

Accepted for publication January 8, 2003.

* Address reprint requests to Dr Morgan, Columbia University, College of Physicians and Surgeons, 177 Fort Washington Avenue, Milstein 7GN-435, New York, NY 10032 USA
e-mail: jm2240{at}columbia.edu

This report describes a 72-year-old woman with atrial fibrillation who presented with lower extremity ischemia secondary to thromboembolism. After lower extremity thrombectomy, the patient developed heparin-induced thrombocytopenia with thrombosis (HITT). Her postoperative course was complicated by recurrent supraventricular and ventricular tachycardia, secondary to a mobile thrombus in the right atrium extending into the right ventricle. Because administration of heparin was contraindicated, the patient underwent off-pump right atrial thrombectomy during a brief period of inflow occlusion. Postoperatively, she was placed on lepirudin. Her platelet count normalized without any further thrombotic episodes, and she was discharged on warfarin.




This article has been cited by other articles:


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A. V Singh, J. T Walsh, and I. S Birdi
Right Atrial Thrombus Masquerading as Intracardiac Cyst: a Case Report
Asian Cardiovasc Thorac Ann, August 1, 2008; 16(4): e35 - e36.
[Abstract] [Full Text] [PDF]


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