A case of difficult anticoagulant management with unexpected heparin resistance during the third great vessel replacement operation

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  • Matsuda Tomoyuki
    Department of anesthesia, Kyoto Okamoto Memorial Hospital Department of intensive care unit, Kyoto Okamoto Memorial Hospital
  • Hashimoto Soshi
    Department of anesthesia, Kyoto Okamoto Memorial Hospital Department of intensive care unit, Kyoto Okamoto Memorial Hospital
  • Yamane Takero
    Department of anesthesia, Kyoto Okamoto Memorial Hospital
  • Morishita Yoko
    Department of anesthesia, Kyoto Okamoto Memorial Hospital
  • Mori Maiko
    Department of anesthesia, Kyoto Okamoto Memorial Hospital
  • Hara Misako
    Department of anesthesia, Kyoto Okamoto Memorial Hospital
  • Tanaka Yoshifumi
    Department of anesthesia, Kyoto Okamoto Memorial Hospital

Bibliographic Information

Other Title
  • 体外循環時の抗凝固管理に難渋した大動脈瘤人工血管置換術の一例
  • 症例報告 体外循環時の抗凝固管理に難渋した大動脈瘤人工血管置換術の一例
  • ショウレイ ホウコク タイガイ ジュンカンジ ノ コウギョウコ カンリ ニ ナンジュウ シタ ダイ ドウミャクリュウ ジンコウ ケッカン チカンジュツ ノ イチレイ

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Abstract

<p>　We reported a case involving a male who showed difficult anticoagulant management with unexpected heparin resistance during the third great vessel replacement operation. He had showed a normal anticoagulant response after the heparin injection in previous operations. The antithrombin activity did not show anything unusual so the cause was not cleared.</p><p>　We used argatroban as a substitute anticoagulant. After that, he showed the appropriate anticoagulant response and the activated clotting time (ACT) was prolonged, so we could induce the extra corporeal circulation (ECC). After a short period, we stopped the argatroban injection in anticipation of the protracted anticoagulant effect. However, he suffered from a difficult hemostasis that lasted for long time after the ECC.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 21 (1), 83-87, 2017

    Japanese Society of Cardiovascular Anesthesiologists

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