Cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia II and impaired renal function using heparin and the platelet GP IIb/IIIa inhibitor tirofiban as anticoagulant

In a patient with heparin-induced thrombocytopenia II and impaired renal fu nction, anticoagulation during cardiopulmonary bypass was successfully perf ormed by the use of unfractionated heparin and the platelet glycoprotein II b/IIIa inhibitor tirofiban. Postoperative antithrombotic therapy with recom binant hirudin was immediately initiated. This regimen for anticoagulation for cardiopulmonary bypass in patients with heparin-induced thrombocytopeni a II appears to be particularly appropriate for patients with impaired rena l function or for hospitals without special experience with other alternati ve anticoagulation strategies. (Ann Thorac Surg 2000;70:2160-1) (C) 2000 by The Society of Thoracic Surgeons.