After cardiopulmonary bypass surgery, the incidence of immunoglobulin antibody (IgG)-mediated heparin-induced thrombocytopenia (HITS) reported in various studies ranges between 1 and 3% as reported by (Anna et al. in Int J Cardiol. 144:405-7, 2010). We report two patients who underwent off-pump coronary artery grafting and developed severe HITS, leading to catastrophic and rare thrombotic complications.
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Anna N, Boyan T, Kader MA, Catherine M, Matthias K. The HIT treatment in a cardiac surgery patient. Int J Cardiol. 2010;144:405–7.
Warkentin TE, Greinacher A. Heparin-induced thrombocytopenia and cardiac surgery. Ann Thorac Surg. 2003;76:2121–31.
Walls JT, Curtis JJ, Silver D, Boley TM, Schmaltz RA, Nawarawong W. Heparin-induced thrombocytopenia in open heart surgical patients: sequelae of late recognition. Ann Thorac Surg. 1992;53:787–91.
Cuker A, Arepally GM, Chong BH, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood Adv. 2018;2:3360–3392.
Lo GK, Juhl D, Warkentin TE, Singouin CS, Eichler P, Greinacher A. Evaluation of present clinical score (4T’s) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings. J Thromb Haemost. 2006;4:759–65.
Joseph WS. Heparin-induced thrombocytopenia. Semin Cardiothorac Vasc Anaesth. 2010;14:73–4.
Ahmed I, Majeed A, Powell R. Heparin induced thrombocytopenia, diagnosis and management update. Postgrad Med J. 2007;83:575–582.
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Rathore, K., Boon, E., Wilson, A. et al. Two cases of heparin-induced thrombocytopenia after off-pump coronary artery bypass surgery. Indian J Thorac Cardiovasc Surg (2020) doi:10.1007/s12055-019-00892-1
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