Download PDF
Thorac Cardiovasc Surg 2005; 53(4): 255-257
DOI: 10.1055/s-2005-865602
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

Pulmonary Embolism After Cesarian Section Due to Heparin-Induced Thrombocytopenia Despite Normal Platelet Count

F.-C. Riess1 , A. Gross2 , U. Budde3
  • 1Department of Cardiac Surgery, Albertinen Hospital, Hamburg, Germany
  • 2Department of Obstetrics and Gynecology, Albertinen Hospital, Hamburg, Germany
  • 3Lab Association Arndt and Partners, Hamburg, Germany
Further Information

Publication History

Received November 2, 2004

Publication Date:
22 July 2005 (online)

    Permissions and Reprints All articles of this category

Abstract

Heparin-induced thrombocytopenia (HIT) type II is typically characterized by a decrease in platelet count to values between 20 and 120 × 109/L or a platelet count fall of greater than 50 %. We report on a patient who developed a HIT syndrome, thrombosis of the vena cava, and fulminant pulmonary embolism during heparin treatment after cesarean section, without a significant decrease in platelet count. Lepirudin anticoagulation and ecarin clotting time (ECT) monitoring were used successfully during cardiopulmonary bypass.

Key words

Heparin-induced thrombocytopenia - platelet count - lepirudin - cardiopulmonary bypass - pulmonary embolism

References

  • 1 Warkentin T E, Greinacher A. Heparin-induced thrombocytopenia and cardiac surgery.  Ann Thorac Surg. 2003;  76 638-648
    CrossrefPubMedSearch in Google Scholar
  • 2 Poetzsch B, Madlener K, Seelig C, Riess F C, Greinacher A, Müller-Berghaus G. Monitoring of r-Hirudin anticoagulation during cardio-pulmonary bypass: assessment of the whole blood ecarin clotting time.  Thromb Haemost. 1997;  77 920-925
    PubMedSearch in Google Scholar
  • 3 Lee D H, Warkentin T E. Frequency of heparin-induced thrombocytopenia:. Warkentin TE, Greinacher A Heparin-Induced Thrombocytopenia. New York; Marcel Dekker 2001: 87-121
    Search in Google Scholar
  • 4 Dahlstrom B L, Nesheim B I. Post partum platelet count in maternal blood.  Acta Obstet Gynecol Scand. 1994;  73 695-697
    PubMedSearch in Google Scholar
  • 5 Hach-Wunderle V, Kainer K, Salzmann G, Müller-Berghaus G, Poetzsch B. Heparin-related thrombosis despite normal platelet counts in vascular surgery.  Am J Surg. 1997;  173 117-119
    CrossrefPubMedSearch in Google Scholar
  • 6 Chilver-Stainer L, Lammle B, Alberio L. Titre of anti-heparin/PF4-antibodies and extent of in vivo activation of the coagulation and fibrinolytic systems.  Thromb Haemost. 2004;  91 276-282
    PubMedSearch in Google Scholar
  • 7 Riess F C, Löwer C, Seelig C, Bleese N, Kormann J, Müller-Berghaus G, Pötzsch B. et al . Recombinant hirudin as a new anticoagulant during cardiac operations instead of heparin: Successful for aortic valve replacement in man.  J Thorac Cardiovasc Surg. 1995;  110 265-267
    PubMedSearch in Google Scholar
  • 8 Gallus A S, Goodall K T, Beswick W, Chesterman C N. Heparin-associated thrombocytopenia: case report and prospective study.  Aust NZ J Med. 1980;  10 25-31
    PubMedSearch in Google Scholar

Dr. Friedich Christian Riess

Albertinen Hospital
Department of Cardiac Surgery

Suentelstraße 11 a

22457 Hamburg

Germany

Phone: + 494055882445 or + 49405252223

Fax: + 49 40 55 88 24 21

Email: Friedrich-Christian.Riess@albertinen.de