A 30 year old lady underwent prosthetic valve replacement surgery done for rheumatic heart disease and she is started on UFH by continuous infusion plus warfarin. Six days after she developed DVT of right lower limb. Her CBC was normal preoperatively and now she has dropped her platelet count to 50,000/mm3. Her INR is 2.3 and APTT is 90 (control 35). The best therapeutic option would be:
A. IVIg followed by steroids
B. Fondaparinux
C. Stop heparin and add aspirin to warfarin
D. Change to low molecular weight heparin
Answer:B
A 30 year old lady underwent prosthetic valve replacement surgery done for rheumatic heart disease and she is started on UFH by continuous infusion plus warfarin. Six days after she developed DVT of right lower limb. Her CBC was normal preoperatively and now she has dropped her platelet count to 50,000/mm3. Her INR is 2.3 and APTT is 90 (control 35). The best therapeutic option would be:
A. IVIg followed by steroids B. Fondaparinux C. Stop heparin and add aspirin to warfarin D. Change to low molecular weight heparin