Heparin-bonded circuit with low systemic anticoagulation in a patient with heparin-induced thrombocytopenia: a case report.
Heparin-induced thrombocytopenia (HIT) in patients undergoing open heart surgery has been reported with increasing frequency. Several strategies have been suggested to approach this difficult problem. However, the syndrome is still associated with significant morbidity and mortality. We describe an 82-year-old male with HIT who underwent coronary artery bypass grafting utilizing a heparin-bonded cardiopulmonary bypass circuit with very low systemic anticoagulation. Only one unit of packed red blood cells was transfused. The patient recovered uneventfully. This strategy is safe and effective, and, therefore, should be considered in patients with HIT.
O'Gara
P J
PJ
Department of Cardiothoracic Surgery, Boston Medical Center, MA 02118, USA. paul.ogara@bmc.org
Aldea
G S
GS
Shemin
R J
RJ
Shapira
O M
OM
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D013921:Thrombocytopenia / Q000139:chemically induced*
D000925:Anticoagulants; D006493:Heparin