在患有II型肝素诱导的血小板减少症的患者中植入HeartMate II

HeartMate II implantation in patients with heparin-induced thrombocytopenia type II.

作者信息

Meyer Anna Lassia, Malehsa Doris, Kuehn Christian, Bara Christoph, Gras Clemens, Hafer Carsten, Haverich Axel, Strüber Martin

机构信息

Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, Germany.

出版信息

Ann Thorac Surg. 2009 Aug;88(2):674-5. doi: 10.1016/j.athoracsur.2008.12.090.

DOI:10.1016/j.athoracsur.2008.12.090

PMID:19632444

Abstract

Diverse anticoagulation protocols are used in patients after implantation of ventricular assist devices. No consensus exists, especially in patients with heparin-induced thrombocytopenia type II. In a patient with heparin-induced thrombocytopenia type II, we implanted a left ventricular assist device (HeartMate XVE; Thoratec, Pleasanton, CA). Thirteen months later the device had to be replaced due to mechanical failure with a HeartMate II left ventricular assist device. We report on our successful protocol of perioperative anticoagulation management using heparin and iloprost during surgery and argatroban thereafter.

摘要

心室辅助装置植入术后的患者使用了多种抗凝方案。目前尚无共识，尤其是在II型肝素诱导的血小板减少症患者中。在一名II型肝素诱导的血小板减少症患者中，我们植入了左心室辅助装置（HeartMate XVE；Thoratec，普莱森顿，加利福尼亚州）。13个月后，由于机械故障，该装置不得不被HeartMate II左心室辅助装置替换。我们报告了我们在手术期间使用肝素和伊洛前列素以及术后使用阿加曲班进行围手术期抗凝管理的成功方案。