We report on a patient suffering from Budd-Chiari disease who developed heparin-induced thrombocytopenia preoperatively. Dorsocranial liver resection and hepatoatrial anastomosis were performed with the extracorporeal circulation and perioperative anticoagulation was achieved with r-hirudin. Surprisingly, thrombus formation was observed in the venous reservoir although ACT was 590 s and aPTT 55 s. An additional bolus of hirudin and rinsing the reservoir allowed unproblematic discontinuation of the cardiopulmonary bypass. Copyright © 2001 Elsevier Science B.V.
Carrel, T., Berdat, P., Schmidli, J., & Gygax, E. (2001). Budd-Chiari syndrome and heparin-induced thrombocytopenia. European Journal of Cardio-Thoracic Surgery, 19(4), 525–527. https://doi.org/10.1016/S1010-7940(01)00625-X