Intraoperative Antiaggregant Strategy for Off-Pump Coronary Artery Bypass Grafting in a Patient with Heparin-Induced Thrombocytopenia
AbstractImmune heparin-induced thrombocytopenia is a rare complication of heparin administration. We describe a patient with a previous diagnosis of heparin-induced thrombocytopenia and related contraindications to anticoagulation who underwent urgent off-pump myocardial revascularization with the administration of only antiaggregant therapy.
Cancio LC, Cohen DJ. 1998. Heparin-induced thrombocytopenia and thrombosis. J Am Coll Surg 186:76-91.nCarr CS, Rayner A, Ponte J, Desai JB. 2005. Off-pump coronary artery bypass grafting in a heparin-induced thrombocytopenia type II patient using hirudin. Ann Thorac Surg 79:696-8.nMerry AF. 2004. Bivalirudin, blood loss, and graft patency in coronary artery bypass surgery. Semin Thromb Hemost 30:337-46.nGlobal Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb investigators. 1996. A comparison of recombinant hirudin with heparin for the treatment of acute coronary syndromes. N Engl J Med 335:775-82.nSpinler SA. 2006. New concepts in heparin-induced thrombocytopenia: diagnosis and management. J Thromb Thrombolysis 21:17-21.n
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