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Journal of anesthesia · Dec 2013
Case ReportsNon-recovery of ACT in a patient with heparin-induced thrombocytopenia type II during mitral valve replacement using argatroban anticoagulation.
- Yoshinori Tanigawa, Tomoko Yamada, Koichi Matsumoto, Akira Nakagawachi, Arisu Torikai, and Yoshirou Sakaguchi.
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan, e6580@cc.saga-u.ac.jp.
- J Anesth. 2013 Dec 1;27(6):951-5.
AbstractArgatroban was used as the anticoagulant during cardiopulmonary bypass (CPB) in a patient with heparin-induced thrombocytopenia (HIT) type II undergoing mitral valve replacement. Dosage was reduced because of preoperative congestive liver disorder. Perioperative coagulability was poor, and, ultimately, failure of hemostasis led to a fatal outcome. Although argatroban use as an anticoagulant for HIT is reported, the optimal dose has not been established. During long-term CPB, increasing the total dosage may extend anticoagulant ability, leading to dose dependence. Because no antagonist for argatroban exists, failure of hemostasis might occur.
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