Emergency cardiopulmonary bypass in a bilaterally nephrectomized patient with a history of heparin-induced thrombocytopenia: Successful reexposure toheparin

We present a case of emergency coronary artery bypass surgery in a bilatera lly nephrectomized patient with a history of heparin-induced thrombocytopen ia. The patient was reexposed short term to heparin during cardiopulmonary bypass and did not develop any complications related to heparin-induced thr ombocytopenia. Despite intraoperative neutralization of heparin severe blee ding complications occurred, probably resulting from preoperative therapeut ic anticoagulation with r-hirudin in conjunction with an increased half-lif e of more than 2 days. (C) 2001 by The Society of Thoracic Surgeons.