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Right arrow Coronary disease

Ann Thorac Surg 2005;79:696-698
© 2005 The Society of Thoracic Surgeons

Case report

Off-Pump Coronary Artery Bypass Grafting in a Heparin-Induced Thrombocytopenia Type II Patient Using Hirudin

Cornélia S. Carr, FRCSa,*, Alan Rayner, ACPa, José Ponte, FRCAa, Jatin B. Desai, FRCSa

a London Bridge Hospital, London, United Kingdom

Accepted for publication September 8, 2003.

* Address reprint requests to Dr Carr, Department of Cardiothoracic Surgery, King's College Hospital, London SE5 9RS, UK
noahalkh{at}talk21.com

Heparin is routinely used for anticoagulation during cardiopulmonary bypass; it is fast acting, is easily monitored, and has an antidote. Heparin-induced thrombocytopenia (HIT) can be a life-threatening condition requiring an alternative anticoagulant (hirudin) if cardiac surgical intervention is considered. At full anticoagulant doses, the effects of hirudin are difficult to monitor; therefore, we present a case in which off-pump coronary artery bypass grafting was performed in an HIT patient in whom the lower doses of hirudin could safely be monitored with easily available tests.




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