Difficulty in the management of anticoagulation with argatroban during off-pump coronary artery bypass grafting
- Matsuyama, Katsuhiko
- Kuinose, Masahiko
- Maruno, Keita
- Takahashi, Satoshi
- Toguchi, Kayo
- Iwahashi, Toru
- Yamamoto, Kiyihito
- Iwasaki, Tomoaki
- Koizumi, Nobusato
- Sato, Masato
- Nishibe, Toshiya
- Ogino, Hitoshi
DOIAbstract
AbstractHeparin-induced thrombocytopenia (HIT) can often result in devastating thromboembolic outcomes. Argatroban is frequently administered as an alternative anticoagulant to heparin. We present a complicated case of HIT in which off-pump coronary artery bypass grafting was performed using anticoagulation with argatroban. Although the active clotting time was maintained between 220 and 270s using argatroban, intraoperative thrombotic complications and postoperative prolonged coagulopathy were encountered.<Learning objective: The use of argatroban involves a potential risk of inadequate anticoagulation or life-threatening postoperative bleeding depending on the dose. We recommend that the target ACT during off-pump coronary artery bypass g...
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