Document Detail

Whole blood hypercoagulability despite anticoagulation during mechanical cardiac assist.
MedLine Citation:
PMID:  18840579     Owner:  NLM     Status:  MEDLINE    
We report hypercoagulability despite activated partial thromboplastin time (APTT)-guided heparin treatment during Berlin Heart-supported circulation in a 38-year-old man with heart failure for 19 days. The patient was anticoagulated using unfractionated heparin, acetylsalicylic acid and dipyridamole. Contact and tissue factor-activated thromboelastometry revealed increased clot firmness, although anticoagulation assessed by APTT was in accordance with the treatment protocol. Strength of polymerized fibrin was also increased. We saw no clinical signs of thrombosis. Thromboelastometry normalized after heart transplantation. Our results suggest that hypercoagulability is due to excess fibrin formation. Monitoring anticoagulation using APTT may, therefore, be misleading during mechanical cardiac assist.
T T Niemi; S I Kukkonen; P T Hämmäinen; R T Suojaranta-Ylinen; J T Sipponen
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Perfusion     Volume:  23     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-10-08     Completed Date:  2009-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  107-10     Citation Subset:  IM    
Departments of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland.
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MeSH Terms
Anticoagulants / administration & dosage*
Fibrin / analysis*
Heart Failure / blood*,  surgery*
Heart Transplantation*
Heart-Assist Devices*
Monitoring, Physiologic / methods
Thrombophilia / blood*,  etiology
Reg. No./Substance:
0/Anticoagulants; 9001-31-4/Fibrin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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