An 81-year-old man with multiple comorbidities developed infected thoracic aortic aneurysm, and we employed a strategic two-step surgical approach combining thoracic endovascular aortic repair and local debridement with an omental flap during the active phase of infection. No signs of reinfection were observed at the 1-year follow-up. This strategy can be a safe and less invasive alternative to conventional open surgery in patients with high surgical risk.
We report a case of a 77-year-old woman with massive pulmonary embolism associated with heparin-induced thrombocytopenia. Before developing a pulmonary embolism, the patient underwent gastrectomy due to gastric cancer and received subcutaneous heparin calcium for deep venous thrombosis prophylaxis for 5 d. Then, thrombectomy with cardiopulmonary bypass using full heparinization was successfully performed. The patient was definitively diagnosed with this condition postoperatively, based on elevated serum antibody levels, in addition to pre-and postoperative thrombocytopenia and thrombosis. Intravenous heparin therapy was switched to argatroban. Although it is uncommon, clinicians should consider this condition in patients with a history of heparin exposure.
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