A Case of Heparin-Induced Thrombocytopenia (HIT) Diagnosed Which Waiting for Off-Pump Coronary Artery Bypass Grafting
10.4326/jjcvs.37.237
- VernacularTitle:術前にヘパリン起因性血小板減少症（HIT）と診断された心拍動下冠動脈バイパス術（OPCAB）の1例
- Author:
Koyu Tanaka
;
Soichi Shioguchi
;
Shigeyoshi Gon
;
Yoshihito Irie
;
Takao Imazeki
- Publication Type:Journal Article
- Keywords:
HIT;
OPCAB
- From:Japanese Journal of Cardiovascular Surgery
2008;37(4):237-239
- CountryJapan
- Language:Japanese
-
Abstract:
A 67-year-old man had angina pectoris due to left main trunk stenosis of coronary artery was transferred to our hospital. Anticoagulation was achieved with a continuous intravenous infusion of 625IU/h heparin. Sixteen days after admission, his platelet count decreased to 14×104/μl, and further decreased to 9.1×104/μl 4 days later. Since we suspected HIT, heparin administration was immediately discontinued, and was substituted with argatroban. A definitive diagnosis of type II HIT was made by a serologic test confirming positive antibodies to the heparin-platelet factor 4 (PF4) complexes. After the platelet count recovered, we performed off-pump CABG (OPCAB) using argatroban. The postoperative course was uneventful and platelet counts was normal. The patient was discharged on the 13th postoperative day. Heparin-induced thrombocytopenia, which causes thrombosis, is a serious side effect of heparin therapy. It is not rare, and in such case argatroban can be useful as an anticoagulant during OPCAB.
