Off-pump coronary artery bypass grafting in a heparin-induced thrombocytopenia type II patient using hirudin.
Heparin is routinely used for anticoagulation during cardiopulmonary bypass; it is fast acting, is easily monitored, and has an antidote. Heparin-induced thrombocytopenia (HIT) can be a life-threatening condition requiring an alternative anticoagulant (hirudin) if cardiac surgical intervention is considered. At full anticoagulant doses, the effects of hirudin are difficult to monitor; therefore, we present a case in which off-pump coronary artery bypass grafting was performed in an HIT patient in whom the lower doses of hirudin could safely be monitored with easily available tests.
Carr
Cornélia S
CS
London Bridge Hospital, London, United Kingdom. noahalkh@talk21.com
Rayner
Alan
A
Ponte
José
J
Desai
Jatin B
JB
D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D004342:Drug Hypersensitivity / Q000150:complications; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006493:Heparin / Q000009:adverse effects*; D006629:Hirudins / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy*
D005343:Fibrinolytic Agents; D006629:Hirudins; D006493:Heparin