Anesthesia & Clinical Research
Open Access

Yutaka Ejima

Publications

• Case Report
  Anticoagulant Managements of Left Ventricular Assist Device Implantation in Two Patients with Heparin-Induced Thrombocytopenia (HIT): Use of Argatroban as an Anticoagulant for Cardiopulmonary Bypass
  
  Author(s): Kazutomo Saito, Hiroaki Toyama, Yutaka Ejima, Kenji Kurotaki, Masanori Yamauchi and Shin Kurosawa Kazutomo Saito, Hiroaki Toyama, Yutaka Ejima, Kenji Kurotaki, Masanori Yamauchi and Shin Kurosawa
  
  Heparin-induced thrombocytopenia (HIT) can cause fatal arterial or venous thrombosis/thromboembolism. In high-risk cases, heparin should be immediately discontinued and an alternative administered; the only alternative permitted in Japan is argatroban, a direct thrombin inhibitor. Anticoagulation in patients with recent HIT requiring cardiopulmonary bypass (CPB) surgery is challenging, because it is sometimes difficult to find out appropriate dosage of argatroban using ACT based monitoring calculation. Two dilated cardiomyopathy patients with HIT were administered argatroban as the anticoagulant for the CPB in left ventricular assist device (LVAD) implantation. After discontinuing argatroban, blood coagulopathy persisted beyond its expected half-life, leading to abnormal haemostasis. Because of severe intraoperative and postoperative bleeding, both patients required massive .. View More»
  DOI: 10.4172/2155-6148.1000525

  Abstract

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