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[Challenging perioperative anticoagulation in a patient with Budd-Chiari syndrome and heparin-induced thrombocytopenia].

Abstract
We report on a patient suffering from Budd-Chiari disease who developed heparin-induced thrombocytopenia preoperatively. Dorsocranial liver resection and hepatoatrial anastomosis were performed with the extracorporeal circulation and perioperative anticoagulation was achieved with r-hirudin. Surprisingly, thrombus formation was observed in the venous reservoir although intraoperative anticoagulation values were within the targeted level. An additional bolus of hirudin and rinsing the reservoir allowed unproblematic discontinuation of the cardiopulmonary bypass.
AuthorsE Gygax, P Berdat, T Carrel
JournalSwiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera (Swiss Surg) Vol. 7 Issue 3 Pg. 141-4 ( 2001) ISSN: 1023-9332 [Print] Switzerland
Vernacular TitleErschwerte perioperative Antikoagulation bei einem Patienten mit Budd-Chiari Syndrom und Heparin induzierter Thrombozytopenie.
PMID11407043 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Hirudins
  • Heparin
Topics
  • Adult
  • Budd-Chiari Syndrome (blood, surgery)
  • Dose-Response Relationship, Drug
  • Extracorporeal Circulation
  • Heart Atria (surgery)
  • Heparin (administration & dosage, adverse effects)
  • Hepatic Veins (surgery)
  • Hirudins (administration & dosage)
  • Humans
  • Infusions, Intravenous
  • Male
  • Partial Thromboplastin Time
  • Recurrence
  • Thrombocytopenia (blood, chemically induced)
  • Venous Thrombosis (drug therapy)

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