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Ann Thorac Surg 2001;72:1730-1732
© 2001 The Society of Thoracic Surgeons

Case report

Off-pump coronary artery bypass grafting for acute heparin-induced thrombocytopenia

Theodore E. Warkentin, MDa, Geoffrey L. Dunn, MDb, Irene J. Cybulsky, MD*c

a Departments of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
b Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
c Department of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada

Accepted for publication December 14, 2000.

* Address reprint requests to Dr Cybulsky, Department of Cardiac Surgery, McMaster University, 7th Floor, Hamilton General Hospital, McMaster Clinic, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
e-mail: cybulsky{at}mcmaster.ca

Surgical revascularization of coronary arteries is problematic for patients with heparin-induced thrombocytopenia because the available nonheparin anticoagulants cannot be reversed pharmacologically. We used three-vessel off-pump coronary artery bypass grafting in a patient with heparin-induced thrombocytopenia, as it allowed us to use substantially lower doses of nonheparin anticoagulant (danaparoid sodium), compared with procedures requiring cardiopulmonary bypass.




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