PMID- 19092745
OWN - NLM
STAT- MEDLINE
DCOM- 20090424
LR  - 20081218
IS  - 0026-4725 (Print)
IS  - 0026-4725 (Linking)
VI  - 56
IP  - 6
DP  - 2008 Dec
TI  - Heparin induced thrombocytopenia in patients with ventricular assistance device 
      bridge-to-transplantation. A case series.
PG  - 697-701
AB  - Heparin-induced thrombocytopenia (HIT), is a severe side effect of heparin. It 
      occurs both in patients treated with unfractionated heparin (UFH) and in patients 
      treated with low molecular weight heparin (LMWH). It is associated with 
      anti-heparin/platelet factor (PF4) antibodies. HIT is a rare pathology, with 
      rates going from 8% to 10% in patients in ventricular assist device support. The 
      authors present three clinical cases which occurred in the Department of 
      Anesthesiology of the Civil Hospital of Strasbourg (France) in patients receiving 
      biventricular assistance bridge-to- cardiac transplantation. All the three 
      patients were hospitalized for myocardial infarction. In case 1 HIT was diagnosed 
      on VI day postoperative after a ventricular assistance device (VAD) implant. The 
      patient was treated with lepirudin and transplanted after 73 days. In case 2 HIT 
      diagnosis was made after 9 days receiving VAD. Also this patient was treated with 
      lepirudin and transplanted after 48 days. Both case 1 and 2 received intra-aortic 
      balloon pump (IABP) assistance before receiving VAD. Case 3 received VAD on XXII 
      day of hospitalization; the patient developed HIT after 5 days, which was treated 
      with lepirudin. He was transplanted after 66 days, but he died in course of 
      intervention. HIT in patients undergoing VAD bridge-to-transplantation is a rare 
      and often misdiagnosed cause of thrombocytopenia. Correct diagnosis, management 
      and therapy are mandatory in this kind of patients, but they are not easy and 
      standardized.
FAU - Nocera, P
AU  - Nocera P
AD  - Department of Anesthesiology, Civil Hospital Strasbourg, France. 
      paulanocera@yahoo.com.br
FAU - Thiranos, J C
AU  - Thiranos JC
FAU - Steib, A
AU  - Steib A
FAU - Morelli, U
AU  - Morelli U
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Italy
TA  - Minerva Cardioangiol
JT  - Minerva cardioangiologica
JID - 0400725
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/*adverse effects
MH  - Heart Transplantation
MH  - *Heart-Assist Devices
MH  - Heparin/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Thrombocytopenia/*chemically induced
EDAT- 2008/12/19 09:00
MHDA- 2009/04/25 09:00
CRDT- 2008/12/19 09:00
PHST- 2008/12/19 09:00 [entrez]
PHST- 2008/12/19 09:00 [pubmed]
PHST- 2009/04/25 09:00 [medline]
PST - ppublish
SO  - Minerva Cardioangiol. 2008 Dec;56(6):697-701.