Cardiopulmonary bypass in patients with heparin-induced thrombocytopenia and thrombosis.
Heparin-induced thrombocytopenia and thrombosis (HITT) is an immunomediated disorder induced by the administration of heparin for therapeutic purposes. The presence of this condition in patients requiring full heparinization for cardiopulmonary bypass constitutes a formidable challenge for the cardiac surgeon. In this review, the clinical and experimental experience described in the literature are discussed in the perspective of the normal coagulation and the pathophysiology of HITT and in the light of a variety of old and new alternative anticoagulants.
Follis
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Department of Cardiothoracic Surgery, University of New Mexico Health Sciences Center, Albuquerque, USA. follis99@hotmail.com
Schmidt
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CA
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001780:Blood Coagulation Tests; D002315:Cardiopulmonary Bypass; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D013927:Thrombosis / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy
D000925:Anticoagulants; D006493:Heparin