Key result
A 57-year-old heart transplant recipient developed early coronary artery thrombosis due to heparin-induced thrombocytopenia and thrombosis syndrome, which was successfully managed with bivalirudin and long-term anticoagulation, leading to complete resolution of thrombi at 5 months.
Case Report (n=1)
No
This case highlights the rare occurrence of early post-transplantation coronary artery thrombosis due to HITTS and demonstrates the utility of cardiac magnetic resonance imaging in diagnosing and guiding the management of allograft myocardial infarction.
Raises awareness of HITTS in early post-transplant thrombosis; hypothesis-generating for bivalirudin-based management.
Cardiac allograft dysfunction is a major cause of morbidity and mortality in the early post-transplantation period. This is a critical condition that requires prompt diagnosis and management. We present the case of a 57-year-old man with ischemic cardiomyopathy who underwent cardiac transplantation and developed a rare case of coronary artery thrombosis in the setting of heparin-induced thrombocytopenia and thrombosis syndrome (HITTS) within the first 2 postoperative weeks. Transmural myocardial infarction (MI) was initially noted on cardiac magnetic resonance (CMR) imaging as regional left ventricular wall motion abnormalities and transmural hyperenhancement after gadolinium administration, prompting further evaluation of the coronary circulation with angiography.
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Torres et al. (2012) conducted a case report in Coronary artery thrombosis and myocardial infarction post-cardiac transplantation (n=1). Bivalirudin and subsequent anticoagulation/antiplatelet therapy was evaluated on Resolution of intracoronary thrombi. A 57-year-old heart transplant recipient developed early coronary artery thrombosis due to heparin-induced thrombocytopenia and thrombosis syndrome, which was successfully managed with bivalirudin and long-term anticoagulation, leading to complete resolution of thrombi at 5 months.
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