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A Case of Re-operation for Paravalvular Leakage after Mitral Valve Replacement Complicated by Heparin-Induced Thrombocytopenia
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（Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan）
| Hiroki Kato |
Noriyoshi Yashiki |
Kenji Iino |
| Shigeyuki Tomita |
Go Watanabe |
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Anticoagulation management in cardiac surgery can be difficult in patients with heparin-induced thrombocytopenia（HIT).
We report a patient who underwent reoperation of cardiopulmonary bypass（CPB）using argatroban in combination with nafamostat mesilate.
A bolus of 0.25mg/kg argatroban was administered, followed by continuous infusion of 5-10μg/kg/min argatroban and 100 mg/h nafamostat mesilate.
No complications such as thrombosis were observed during either CPB or the perioperative period.
Although we used argatroban and nafamostat mesilate, which has a shorter half-life than argatroban, the anticoagulant effect was prolonged, and the patient had an uneventful postoperative course despite requiring substantial blood transfusion.
Jpn. J. Cardiovasc. Surg. 40:112-114（2011）
Keywords：heparin-induced thrombocytopenia, cardiopulmonary bypass, reoperation, argatroban, nafamostat mesilate
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