Endoscopic Cholecystectomy in a 55-year-old Patient with Heparin-Induced Thrombocytopenia Type II and Replacement of Mitral and Aortic Valve and Tricuspid Valve Anular Plasty

Abstract

Heparin-induced thrombocytopenia (HIT) at present is the most common medicine induced thrombocytopenia. HIT type II, in which activation of platelets is immunologically mediated, represents a serious complication of heparin therapy while severe thromboembolic complications can occur which sometimes result in the loss of extremity if application of heparin is not terminated immediately. Further anticoagulation in patients with HIT type II includes the application of danaparoidsodium (1) or recombinant hirudin (2). The present study presents the laboratory findings with different doses of hirudin and the clinical course of a 55-year-old patient with HIT type II and replacement of mitral valve, aortic valve and tricuspid valve anular plasty in whom Lepirudin (Refludan) was applied perioperative during endoscopic cholecystectomy.