Heparin-induced thrombocytopenia and thrombosis syndrome after cardiac surgery.
A case report of multisystem organ failure and limb loss associated with coronary artery bypass is reported. Heparin-induced thrombocytopenia and thrombosis syndrome (HITTS) occurs in 1% to 2% of patients suffering from thrombocytopenia associated with heparin or heparinoid use, which amounts to less than 1.4% of the cardiac surgical population. It carries a risk of significant comorbidity and mortality. Providers involved in the care of such patients should be well versed in the etiology and potential complications of HITTS, the treatment options, and alternative modalities of anticoagulation available for use.
DuBose
Joseph
J
Department of Surgery, Keesler Medical Center, Keesler Air Force Base, Suite 1A132, 301 Fisher Street, MS 30534, USA.
Sutherland
Michael
M
Moulton
Michael
M
Krishnan
Bhaktan
B
Cohn
Jerry
J
Pratt
Jerry W
JW
D000671:Amputation, Surgical; D000925:Anticoagulants / Q000009:adverse effects*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery; D002432:Cecum / Q000098:blood supply; D003082:Colectomy; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004797:Enzyme-Linked Immunosorbent Assay; D005434:Flow Cytometry; D006493:Heparin / Q000009:adverse effects*; D024764:Hirudin Therapy; D006801:Humans; D007081:Ileostomy; D007511:Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D010976:Platelet Count; D012307:Risk Factors; D013577:Syndrome; D013921:Thrombocytopenia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D000925:Anticoagulants; D006493:Heparin