Recurrent left atrial and left ventricular thrombosis due to heparin-induced thrombocytopenia: case report and short review

Thorac Cardiovasc Surg. 2013 Sep;61(6):537-40. doi: 10.1055/s-0032-1328930. Epub 2013 Feb 19.

Abstract

The combination of heparin-induced thrombocytopenia (HIT) II, left ventricular failure with extracorporeal membrane oxygenation (ECMO) therapy, and recurrent left ventricular thrombosis is rare and predicts a poor outcome. In this case, HIT II occurred after an ischemic cardiogenic shock. We initiated ECMO and intra-aortic balloon pump therapy during coronary artery bypass grafting and ventricular thrombectomy. Despite continued therapeutic therapy with heparin and later argatroban, the patient developed solid and recurrent thrombotic masses in the left atrium and left ventricle.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Coronary Artery Bypass
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Fatal Outcome
  • Heart Diseases / chemically induced*
  • Heart Diseases / diagnosis
  • Heart Diseases / therapy
  • Heparin / adverse effects*
  • Humans
  • Intra-Aortic Balloon Pumping
  • Male
  • Middle Aged
  • Recurrence
  • Shock, Cardiogenic / therapy*
  • Thrombectomy
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / diagnosis
  • Thrombosis / chemically induced*
  • Thrombosis / diagnosis
  • Thrombosis / therapy
  • Treatment Outcome

Substances

  • Anticoagulants
  • Heparin