Coronary arterial bypass surgery with beating heart in a patient with heparin-induced thrombocytopenia: Usage of thrombin inhibitor (Lepirudin; r-hirudin)

• Authors: Bilgehan Erkut , Necip Becit , Serpil Diler , Munacettin Ceviz
• Languages of publication: EN

Abstracts

EN

One of the most important adverse drug reactions that physicians encounter is the life-threatening prothrombotic syndrome known as heparin-induced thrombocytopenia (HIT). In patients with a history of heparin-induced thrombocytopenia and coronary arterial disease, alternative anticoagulatory regimens are needed during cardiac surgery for prevention of thrombosis. Treatment options for such patients now generally include the use of alternative anticoagulants such as lepirudin, bivalirudin, argatroban or danaparoid. In this article, we present a case where heparin-induced thrombocytopenia was properly performed coronary arterial bypass grafting by using lepirudin. (This sentence is confusing)

Keywords

EN

Lepirudin; Heparin-induced thrombocytopenia; Coronary arterial bypss surgery; Heparin; Anticoagulation

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2010
• Volume: 5
• Issue: 2
• Pages: 150-153

Dates

published

1 - 4 - 2010

online

17 - 4 - 2010

Contributors

author

Bilgehan Erkut

• Cardiovascular Surgery Department, Erzurum Regional Training and Research Hospital, 25020, Erzurum, Turkey

author

Necip Becit

• Cardiovascular Surgery Department, Atatürk University Medical Faculty, 25080, Erzurum, Turkey

author

Serpil Diler

• Cardiovascular Surgery Department, Atatürk University Medical Faculty, 25080, Erzurum, Turkey

author

Munacettin Ceviz

• Cardiovascular Surgery Department, Atatürk University Medical Faculty, 25080, Erzurum, Turkey

References

• [1] Greinacher A, Janssens U, Berg G, Böck M, Kwasny H, Kemkes-Matthes B, Eichler P, Völpel H, Pötzsch B, Luz M. Lepirudin (recombinant hirudin) for parenteral anticoagulation in patients with HIT, Circulation, 1999, 100, 587–593
• [2] Warkentin TE, Chong BH, Greinacher A. Heparin-induced thrombocytopenia: towards consensus, Thromb Haemost, 1998, 79, 1–7.
• [3] Amiral J, Marfaing-Koka A, Wolf M, Alessi MC, Tardy B, Boyer-Neumann C, Vissac AM, Fressinaud E, Poncz M, Meyer D. Presence of autoantibodies to interleucin-8 or neutrophil-activating peptide-2 in patients with heparin-associated thrombocytopenia, Blood, 1996, 88, 410–416
• [4] Greinacher A, Michels I, Mueller-Eckhardt C. Heparin associated thrombocytopenia: the antibody is not heparin specific, Thromb Haemost, 1992, 67, 545–549
• [5] Gajra A, Vajpayee N, Smith A, Poiesz BJ, Narsipur S. Lepirudin for anticoagulation in patients with heparin-induced thrombocytopenia treated with continuous renal replacement therapy, Am J Hematol, 2006, 82, 391–393 http://dx.doi.org/10.1002/ajh.20820[Crossref][WoS]
• [6] Warkentin TE. Heparin-induced thrombocytopenia: pathogenesis and management. Br J Haematol, 2003, 121, 535–555 http://dx.doi.org/10.1046/j.1365-2141.2003.04334.x[Crossref]
• [7] Warkentin TE, Roberts RS, Hirsh J, Kelton JG. An improved definition of immune heparin-induced thrombocytopenia in postoperative orthopedic patients. Arch Intern Med, 2003, 163, 2518–2524 http://dx.doi.org/10.1001/archinte.163.20.2518[Crossref]
• [8] Glock Y, Szmil E, Boudjema B, Boccalon H, Fournial G, Cerene AL, Puel P. Cardiovascular surgery and heparin-induced thrombocytopenia, Int Angiol, 1988, 7, 238–245
• [9] Blakeman B. Management of heparin-induced thrombocytopenia: a cardiovascular surgeon’s perspective, Semin Hematol, 1999, 36, 37–41
• [10] Lewis BE, Wallis DE, Berkowitz SD, Matthai WH, Fareed J, Walenga JM, Bartholomew J, Sham R, Lerner RG, Zeigler ZR, Rustagi PK, Jang IK, Rifkin SD, Moran J, Hursting MJ, Kelton JG. Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation, 2001, 103, 1838–1843
• [11] Greinacher A, Lubenow N. Recombinant hirudin in clinical practice: focus on lepirudin, Circulation, 2001, 103, 1479–1484
• [12] Singer RL, Mannion JD, Bauer TL, Armenti FR, Edie RN. Complications from heparin-induced thrombocytopenia in patients undergoing cardiopulmonary bypass, Chest, 1993, 104, 1436–1440 http://dx.doi.org/10.1378/chest.104.5.1436[Crossref]
• [13] Lee DH, Warkentin TE: Frequency of heparin-induced thrombocytopenia. In: Warkentin TE, Greinacher A, eds. Heparin-Induced Thrombocytopenia. 3rd ed. New York: Marcel Dekker, 2004, 107–163
• [14] Ganzer D, Gutezeit A, Mayer G. Potential risks in drug prevention of thrombosis-low-molecular-weight heparin versus standard heparin, Z Orthop Ihre Grenzgeb, 1999, 137, 457–461 http://dx.doi.org/10.1055/s-2008-1037391[Crossref]
• [15] Farner B, Eichler P, Kroll H, Greinacher A. A comparison of danaparoid and lepirudin in heparin-induced thrombocytopenia, Thromb Haemost, 2001, 85, 950–957
• [16] Potzsch B, Madlener K, Seelig C, Riess CF, Greinacher A, Müller-Berghaus G. Monitoring of r-hirudin anticoagulation during cardiopulmonary bypass-assessment of the whole blood ECT, Thromb Haemost, 1997, 77, 920–925

Identifiers

DOI

10.2478/s11536-009-0138-y