A Case of Heparin-Induced Thrombocytopenia (HIT) Diagnosed Which Waiting for Off-Pump Coronary Artery Bypass Grafting

A 67-year-old man had angina pectoris due to left main trunk stenosis of coronary artery was transferred to our hospital. Anticoagulation was achieved with a continuous intravenous infusion of 625IU/h heparin. Sixteen days after admission, his platelet count decreased to 14×104/μl, and further decre...

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Veröffentlicht in:Japanese Journal of Cardiovascular Surgery 2008/07/15, Vol.37(4), pp.237-239
Hauptverfasser: Tanaka, Koyu, Shioguchi, Soichi, Gon, Shigeyoshi, Irie, Yoshihito, Imazeki, Takao
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Sprache:jpn
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Zusammenfassung:A 67-year-old man had angina pectoris due to left main trunk stenosis of coronary artery was transferred to our hospital. Anticoagulation was achieved with a continuous intravenous infusion of 625IU/h heparin. Sixteen days after admission, his platelet count decreased to 14×104/μl, and further decreased to 9.1×104/μl 4 days later. Since we suspected HIT, heparin administration was immediately discontinued, and was substituted with argatroban. A definitive diagnosis of type II HIT was made by a serologic test confirming positive antibodies to the heparin-platelet factor 4 (PF4) complexes. After the platelet count recovered, we performed off-pump CABG (OPCAB) using argatroban. The postoperative course was uneventful and platelet counts was normal. The patient was discharged on the 13th postoperative day. Heparin-induced thrombocytopenia, which causes thrombosis, is a serious side effect of heparin therapy. It is not rare, and in such case argatroban can be useful as an anticoagulant during OPCAB.
ISSN:0285-1474
1883-4108
DOI:10.4326/jjcvs.37.237