Abstract
We report a case of a management of anticoagulation with heparin in patients with tongue carcinoma (T3N0M0). A 66-year-old female was referred to our hospital with a complaint of an ulcer of the left border of the tongue. She had received the mitral and tricuspid valve replacement surgery after a diagnosis of their valve closure and stenosis at the age of 49. Warfarin at 2.5mg/day and Panaldine at 100mg/day was admimistrated for her anticoagulation. She had complicated with atrial fibration and a high risk of a thrombus formation at the replaced valves in a short time of increased coagulation.
Seven days preoperatively, Warfarin administrated her was changed to heparin, there after it was stopped to 6 hours prior to the glossectomy. After two hours the heparin was restarted with 500 units/hr and replaced to Warfarin. We successfully managed her without bleeding and clotting when heparin sodium was administered in an ACT range of 130-150 seconds.
We experienced that the replacement of Warfarin to the heparin provided good perioperative management to ACT against the patient with anticoagulation.
