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Ann Thorac Surg 2000;70:2173-2181
© 2000 The Society of Thoracic Surgeons

Current review

Cardiopulmonary bypass in patients with heparin-induced thrombocytopenia and thrombosis

Fabrizio Follis, MDa, Carlos A. Schmidt, MDb

a Department of Cardiothoracic Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
b Department of Cardiac Surgery, St. Anthony’s Central Hospital, and Department of Cardiac Surgery, Lutheran Medical Center, Denver, Colorado, USA

Address reprint requests to Dr Follis, Department of Cardiac Surgery, Ospedale Civico di Palermo, via Carmelo Lazzaro, Palermo, Italy
e-mail: follis99{at}hotmail.com

Heparin-induced thrombocytopenia and thrombosis (HITT) is an immunomediated disorder induced by the administration of heparin for therapeutic purposes. The presence of this condition in patients requiring full heparinization for cardiopulmonary bypass constitutes a formidable challenge for the cardiac surgeon. In this review, the clinical and experimental experience described in the literature are discussed in the perspective of the normal coagulation and the pathophysiology of HITT and in the light of a variety of old and new alternative anticoagulants.




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