Document Detail


Whole blood hypercoagulability despite anticoagulation during mechanical cardiac assist.
MedLine Citation:
PMID:  18840579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T T Niemi; S I Kukkonen; P T Hämmäinen; R T Suojaranta-Ylinen; J T Sipponen
Related Documents :
10915479 - The emergency use of recombinant hirudin in cardiopulmonary bypass.
9505919 - Screening for atrial fibrillation in primary care.
15918449 - Coagulation management of a patient with factor v leiden mutation, lupus anticoagulant,...
7199639 - Recurrent embolic cerebral infarction and anticoagulation.
10514209 - Systematic review of randomized controlled trials of aspirin and oral anticoagulants in...
7832599 - Physician attitudes about anticoagulation for nonvalvular atrial fibrillation in the el...
17967939 - Atrial antifibrillatory effects of structurally distinct ikur blockers 3-[(dimethylamin...
11430529 - Cardiac nuclear medicine in monitoring patients with coronary heart disease.
2916539 - Serum triglycerides as an independent risk factor for death from coronary heart disease...
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    
Affiliation:
Departments of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. tomi.niemi@hus.fi
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / administration & dosage*
Fibrin / analysis*
Heart Failure / blood*,  surgery*
Heart Transplantation*
Heart-Assist Devices*
Humans
Male
Monitoring, Physiologic / methods
Thrombelastography
Thrombophilia / blood*,  etiology
Chemical
Reg. No./Substance:
0/Anticoagulants; 9001-31-4/Fibrin

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


Previous Document:  Transportation of critically ill patients on extracorporeal membrane oxygenation.
Next Document:  Carvedilol reduces myocardial no-reflow by decreasing endothelin-1 via activation of the ATP-sensiti...