PMID- 34967780
OWN - NLM
STAT- MEDLINE
DCOM- 20220908
LR  - 20220916
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 68
IP  - 9
DP  - 2022 Sep 1
TI  - Management of Heparin-Induced Thrombocytopenia Using Plasmapharesis in Patients 
      Undergoing HeartMate 3 Left Ventricular Assist Device.
PG  - e152-e155
LID - 10.1097/MAT.0000000000001631 [doi]
AB  - Heparin-induced thrombocytopenia (HIT) type-2 is a rare, but life-threatening 
      complication that presents a unique challenge in patients undergoing cardiac 
      surgery. Patients that require cardiac surgery with HIT present a dilemma between 
      intraoperative anticoagulation, perioperative bleeding risk, and perioperative 
      thrombotic events. We describe a case series of four patients who developed HIT 
      in their hospital course before HeartMate 3 (HM3) left ventricular assist device 
      implantation. Following a multidisciplinary approach, all patients did well 
      intraoperatively with an approach of preoperative plasmapheresis, intraoperative 
      unfractionated heparin (UFH), and postoperative conversion to bivalirudin with a 
      bridge to warfarin. However, two patients had postoperative bleeding 
      complications on bivalirudin. This case series details the therapeutic challenges 
      encountered for HM3 implantation in patients with HIT and offers a therapeutic 
      alternative to intraoperative bivalirudin in the effort to decrease perioperative 
      complications in this challenging patient population.
CI  - Copyright (c) ASAIO 2021.
FAU - Naqvi, Syed Yaseen
AU  - Naqvi SY
AD  - From the Department of Advanced Heart Failure and Transplantation, Division of 
      Cardiology, University of Rochester Medical Center.
FAU - Jawaid, Anas
AU  - Jawaid A
FAU - Dao, Benjamin
AU  - Dao B
FAU - Falvey, Jennifer
AU  - Falvey J
AUID- ORCID: 0000-0002-7601-886
FAU - Vidula, Himabindu
AU  - Vidula H
FAU - Gosev, Igor
AU  - Gosev I
FAU - Thomas, Sabu
AU  - Thomas S
LA  - eng
PT  - Journal Article
DEP - 20211228
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - 0 (Anticoagulants)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - Blood Coagulation
MH  - *Heart-Assist Devices/adverse effects
MH  - Heparin/therapeutic use
MH  - Hirudins/adverse effects
MH  - Humans
MH  - Peptide Fragments/therapeutic use
MH  - Recombinant Proteins/therapeutic use
MH  - *Thrombocytopenia/chemically induced/therapy
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2021/12/31 06:00
MHDA- 2022/09/09 06:00
CRDT- 2021/12/30 12:44
PHST- 2021/12/31 06:00 [pubmed]
PHST- 2022/09/09 06:00 [medline]
PHST- 2021/12/30 12:44 [entrez]
AID - 00002480-202209000-00020 [pii]
AID - 10.1097/MAT.0000000000001631 [doi]
PST - ppublish
SO  - ASAIO J. 2022 Sep 1;68(9):e152-e155. doi: 10.1097/MAT.0000000000001631. Epub 2021 
      Dec 28.