Journal Article

Heparin induced thrombocytopenia type II complicating coronary artery bypass surgery: a tale of caution

Uday Dandekar, Jonathan Young, Maninder Kalkat and Christopher M.R. Satur

in Interactive CardioVascular and Thoracic Surgery

Published on behalf of European Association for Cardio-Thoracic Surgery

Volume 3, issue 1, pages 121-123
Published in print March 2004 | ISSN: 1569-9293
Published online March 2004 | e-ISSN: 1569-9285 | DOI: https://dx.doi.org/10.1016/S1569-9293(03)00231-7
Heparin induced thrombocytopenia type II complicating coronary artery bypass surgery: a tale of caution

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  • Gastroenterology
  • Anatomy
  • Cardiovascular Medicine
  • Surgical Oncology

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Objective: To highlight an uncommon problem of heparin induced thrombocytopenia after coronary artery bypass operation. Methods: We report the case of a 59-year-old man who suffered severe type II heparin induced thrombocytopenia (HIT) after coronary artery bypass operation. He experienced extensive skin necrosis at sites of saphenous vein harvesting, which progressed to cause soft tissue necrosis of both feet. He also exhibited secondary clinical features arising from pulmonary, hepatic and renal dysfunction suggestive of extensive venous thrombosis. Primary treatment of the haematological disorder was achieved by discontinuation of all forms of heparin and the administration of a heparinoid intravenously. Secondary treatment included forefoot amputations and skin grafting. Results: Though the patient suffered a protracted period of recovery he was discharged home well. Conclusion: We have reported this complex case in order to familiarise cardiothoracic surgeons with the extreme characteristics of type II HIT and to emphasise that early diagnosis and treatment will facilitate a successful outcome.

Keywords: Heparin induced thrombocytopenia; Cardiac surgery

Journal Article.  1292 words.  Illustrated.

Subjects: Gastroenterology ; Anatomy ; Cardiovascular Medicine ; Surgical Oncology

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