Preoperative plasmapheresis and limited heparin use allowed for safe cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia.
May enable safe CPB in HIT via preoperative plasmapheresis and limited heparin; leaves open prospective validation.
Patients with documented history of heparin-induced thrombocytopenia (HIT) pose a difficult problem during surgery using cardiopulmonary bypass (CPB). Several alternatives to heparin exist, but these products either are not approved for use in the United States or have more side effects than heparin. We report on a patient with documented heparin-induced antibody and left main coronary artery disease who underwent uneventful coronary artery bypass surgery and recovery by using preoperative plasmaphresis and limited use of porcine intestinal heparin during CPB.
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Kajitani et al. (2001) studied this question.
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