title: Heparin-induced thrombosis without thrombocytopenia causing fulminant pulmonary embolism after off-pump coronary artery bypass grafting.
abstract: Heparin-induced thrombocytopenia (HIT) is a rare immune-mediated complication of heparin administration. A potentially life-threatening complication, HIT is difficult to diagnose in patients in the intensive care unit after cardiac surgery because there can be multiple reasons for thrombocytopenia. Moreover, immune-mediated platelet consumption may be masked by reactive thrombocytosis, which is common in the typical postoperative course after cardiac surgery. We report the case of a 57-year-old male patient who developed fulminant pulmonary embolism following heparin-induced thrombosis without thrombocytopenia after off-pump coronary artery bypass surgery.
authors.affiliation: Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig Maximilians University, Marchioninistr. 15, D-81377 München, Germany. Amir_Khosrow.Bigdeli@med.uni-muenchen.de
authors.forename: Amir K
authors.initials: AK
authors.lastname: Bigdeli
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmitz
authors.forename: Dirk
authors.initials: D
authors.lastname: Bruegger
authors.forename: Florian
authors.initials: F
authors.lastname: Weis
authors.forename: Marion
authors.initials: M
authors.lastname: Weis
authors.forename: Sebastian
authors.initials: S
authors.lastname: Michel
authors.forename: Daniel
authors.initials: D
authors.lastname: Schmauss
authors.forename: Daniel
authors.initials: D
authors.lastname: Reichart
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
authors.forename: Ralf
authors.initials: R
authors.lastname: Sodian
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D006331:Heart Diseases / Q000209:etiology*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*; D013921:Thrombocytopenia / Q000209:etiology*; D013927:Thrombosis / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D006493:Heparin