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Ann Thorac Surg 1994;57:1326-1328
© 1994 The Society of Thoracic Surgeons

Articles

Successful treatment of massive pulmonary embolism after coronary artery bypass grafting due to heparin-induced thrombocytopenia

Anthony C. Ralph-Edwards, MD, Christopher M. Feindel, MD*, Michael F.X. Glynn, MD

Departments of Cardiovascular Surgery and Hematology, University of Toronto, Toronto Hospital, General Division, Toronto, Ontario, Canada

Accepted for publication August 13, 1993.

* Address reprint requests to Dr Feindel, Division of Cardiovascular Surgery, The Toronto Hospital, 200 Elizabeth St, 14 Eaton N-222, Toronto, Ont, M5G 2C4, Canada.


   Abstract
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 Abstract
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Massive pulmonary embolism is a rare complication in patients undergoing coronary artery bypass grafting. Frequently patients have had exposure to heparin before the operation. In this article we report a patient who 6 days after a cardiac operation suffered a massive pulmonary embolism. The patient was later discovered to have heparin-associated thrombocytopenia with serum heparin antibody. We recommend patients receiving heparin have frequent platelet counts and those with induced thrombocytopenia undergo sensitivity testing.


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  1. Gillinov AM, Davis EA, Alberg AJ, Rykiel M, Gardner TJ, Cameron DE. Pulmonary embolism in the cardiac surgical patient Ann Thorac Surg 1992;53:988-991.[Abstract/Free Full Text]
  2. Rhodes GR, Dixcit RH, Silver D. Heparin induced thrombocytopenia with thrombotic and hemorrhagic manifestations Surg Gynecol Obstet 1973;136:409-416.[Medline]
  3. Silver D, Kapsch DN, Tsoi EKM. Heparin-induced thrombocytopenia, thrombosis, and hemorrhage Ann Surg 1983;198:301-305.[Medline]
  4. Walls JT, Curtis JJ, Silver D, Boley TM, Schmaltz RA, Nawarawong W. Heparin-induced thrombocytopenia in open heart surgical patients: sequelae of late recognition Ann Thorac Surg 1992;53:787-791.[Abstract/Free Full Text]
  5. Smith JP, Walls JT, Muscato MS, et al. Extracorporeal circulation in a patient with heparin-induced thrombocytopenia Anesthesiology 1985;62:363-365.[Medline]



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This Article
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Google Scholar
Right arrow Articles by Ralph-Edwards, A. C.
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PubMed
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Right arrow Articles by Ralph-Edwards, A. C.
Right arrow Articles by Glynn, M. F. X.