Download PDF
CC BY 4.0 · TH Open 2018; 02(03): e334-e337
DOI: 10.1055/s-0038-1672188
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Massive Left Atrial Thrombus in Two Patients with Heparin-Induced Thrombocytopenia Type II after Cardiac Surgery

Yuriy Mandryk
1   Department of Cardiac Surgery, Klinikum Passau, Passau, Germany
,
Markus Czesla
1   Department of Cardiac Surgery, Klinikum Passau, Passau, Germany
,
Christian Mogilansky
1   Department of Cardiac Surgery, Klinikum Passau, Passau, Germany
,
Kristina Stefkova
2   Department for Laboratory Medicine, Klinikum Passau, Passau, Germany
,
Aloys Drees
2   Department for Laboratory Medicine, Klinikum Passau, Passau, Germany
,
Parwis Massoudy
1   Department of Cardiac Surgery, Klinikum Passau, Passau, Germany
› Author Affiliations
Further Information

Publication History

11 January 2018

16 August 2018

Publication Date:
26 September 2018 (online)

Also available at
   Permissions and Reprints

Abstract

Heparin-induced thrombocytopenia type II (HIT type II) can have devastating consequences in cardiac surgical patients. We report two cases of massive left atrial thrombus after mitral valve replacement and endocardial cryoablation in patients with HIT type II.

Keywords

heparin-induced thrombocytopenia - argatroban - mitral valve replacement - endocardial cryoablation
 

  • References

  • 1 Althaus K, Hron G, Strobel U. , et al. Evaluation of automated immunoassays in the diagnosis of heparin induced thrombocytopenia. Thromb Res 2013; 131 (03) e85-e90
    CrossrefPubMedGoogle Scholar
  • 2 Legnani C, Cini M, Pili C, Boggian O, Frascaro M, Palareti G. Evaluation of a new automated panel of assays for the detection of anti-PF4/heparin antibodies in patients suspected of having heparin-induced thrombocytopenia. Thromb Haemost 2010; 104 (02) 402-409
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Juhl D, Eichler P, Lubenow N, Strobel U, Wessel A, Greinacher A. Incidence and clinical significance of anti-PF4/heparin antibodies of the IgG, IgM, and IgA class in 755 consecutive patient samples referred for diagnostic testing for heparin-induced thrombocytopenia. Eur J Haematol 2006; 76 (05) 420-426
    CrossrefPubMedGoogle Scholar
  • 4 Greinacher A, Michels I, Kiefel V, Mueller-Eckhardt C. A rapid and sensitive test for diagnosing heparin-associated thrombocytopenia. Thromb Haemost 1991; 66 (06) 734-736
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Greinacher A. Heparin-induced thrombocytopenia. J Thromb Haemost 2009; 7 (01) (Suppl. 01) 9-12
    CrossrefPubMedGoogle Scholar
  • 6 Vazquez-Jimenez JF, Janssens U, Sellhaus B. , et al. Thrombosis of a mitral valve prosthesis in a patient with heparin-induced thrombocytopenia type II. J Thorac Cardiovasc Surg 1999; 118 (04) 751-753
    CrossrefPubMedGoogle Scholar
  • 7 Campisi S, Fuzellier JF, Vola M, Favre JP. Giant left ventricular thrombus formation associated with heparin-induced thrombocytopenia. Ann Thorac Surg 2014; 98 (06) e143-e145
    CrossrefPubMedGoogle Scholar
  • 8 Kuhl T, Wendt S, Langebartels G, Kröner A, Wahlers T. Recurrent left atrial and left ventricular thrombosis due to heparin-induced thrombocytopenia: case report and short review. Thorac Cardiovasc Surg 2013; 61 (06) 537-540
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Sidhu M, Goel P, Singh HP, Chopra AK, Arora R, Sidhu S. Acute bioprosthetic mitral valve stenosis in a patient with HITS. J Card Surg 2011; 26 (04) 369-371
    CrossrefPubMedGoogle Scholar
  • 10 Warkentin TE, Levine MN, Hirsh J. , et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med 1995; 332 (20) 1330-1335
    CrossrefPubMedGoogle Scholar
  • 11 Take A, Yamaguchi T, Horimi H, Kato M, Hasegawa T. Left atrial thrombus in the early postoperative period after mitral valve replacement [in Japanese]. Nippon Kyobu Geka Gakkai Zasshi 1991; 39 (07) 1039-1048
    PubMedGoogle Scholar
  • 12 Mack CA, Milla F, Ko W. , et al. Surgical treatment of atrial fibrillation using argon-based cryoablation during concomitant cardiac procedures. Circulation 2005; 112 (9, Suppl): I1-I6
    CrossrefPubMedGoogle Scholar
  • 13 Tanaka K, Aso K, Kumate M, Aoyagi S, Kosuga K, Ohishi K. Left atrial thrombosis after mitral valve replacement [in Japanese]. Kyobu Geka 1990; 43 (04) 291-295
    PubMedGoogle Scholar
  • 14 Barth K, Hanke C, Nakamura L, Zieger B, Arnold R, Stiller B. Heparin induzierte Thrombozytopenie II (HIT II) bei 6-jährigem Jungen nach Herzoperation. Paper presented at: Jahrestagung der Süddeutschen Gesellschaft für Kinderheilkunde und Jugendmedizin gemeinsam mit der Süddeutschen Gesellschaft für Kinderchirugie; May 15, 2009; Karlsruhe, Germany
    PubMedGoogle Scholar