Mitchell Christina, Riley Catherine A, Vahid Bobbak
Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Ann Thorac Surg. 2007 Mar;83(3):1172-4. doi: 10.1016/j.athoracsur.2006.08.047.
A 64-year-old man presented with cardiac tamponade 2 weeks after mitral valve surgery. The patient was anticoagulated for persistent atrial fibrillation after cardiac surgery. A pericardial catheter was placed. Five days after presentation the patient was started on intravenous heparin infusion. The patient had abdominal pain and hypotension develop. A splenic hematoma was diagnosed and a splenectomy was performed. Pathology showed multiple fibrin thrombi in the spleen. The heparin-associated antibodies were detected. Heparin-induced thrombocytopenia is a potentially fatal condition in patients requiring heparin after cardiac surgery. Evaluation for heparin-associated antibodies in these patients may be warranted before heparin therapy.
一名64岁男性在二尖瓣手术后2周出现心脏压塞。该患者因心脏手术后持续性房颤接受抗凝治疗。放置了心包导管。就诊5天后，患者开始静脉输注肝素。患者出现腹痛和低血压。诊断为脾血肿并进行了脾切除术。病理显示脾脏有多个纤维蛋白血栓。检测到肝素相关抗体。肝素诱导的血小板减少症对于心脏手术后需要肝素治疗的患者来说是一种潜在致命的疾病。在这些患者进行肝素治疗前，可能有必要评估肝素相关抗体。
