A Case of Re-operation for Paravalvular Leakage after Mitral Valve Replacement Complicated by Heparin-Induced Thrombocytopenia
10.4326/jjcvs.40.112
- VernacularTitle:へパリン起因性血小板減少症を合併した僧帽弁位人工弁周囲逆流に対する再手術の1例
- Author:
Hiroki Kato
;
Noriyoshi Yashiki
;
Kenji Iino
;
Shigeyuki Tomita
;
Go Watanabe
- Publication Type:Journal Article
- Keywords:
heparin-induced thrombocytopenia;
cardiopulmonary bypass;
reoperation;
argatroban;
nafamostat mesilate
- From:Japanese Journal of Cardiovascular Surgery
2011;40(3):112-114
- CountryJapan
- Language:Japanese
-
Abstract:
Anticoagulation management in cardiac surgery can be difficult in patients with heparin-induced thrombocytopenia (HIT). We report a patient who underwent reoperation of cardiopulmonary bypass (CPB) using argatroban in combination with nafamostat mesilate. A bolus of 0.25 mg/kg argatroban was administered, followed by continuous infusion of 5-10 μg/kg/min argatroban and 100 mg/h nafamostat mesilate. No complications such as thrombosis were observed during either CPB or the perioperative period. Although we used argatroban and nafamostat mesilate, which has a shorter half-life than argatroban, the anticoagulant effect was prolonged, and the patient had an uneventful postoperative course despite requiring substantial blood transfusion.
