4.2 Article

How would we treat our own heparin-induced thrombocytopenia during cardiac surgery?

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.jvca.2020.11.002

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heparin-induced thrombocytopenia; intravenous polyvalent immunoglobulin; immune complexes; Fc gamma RIIa receptor polymorphism; non-heparin-based anticoagulation; cardiac surgery

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This article aims to provide a comprehensive review of current knowledge on heparin-induced thrombocytopenia (HIT) in cardiac surgery and discuss the perioperative therapeutic options for HIT patients undergoing urgent cardiac surgery with cardiopulmonary bypass, which require an interdisciplinary and patient-tailored approach. Patient management should be individualized and rely on limited evidence and potential risks.
The aim of this article is to provide a comprehensive review of the current state of knowledge on heparin-induced thrombocytopenia (HIT) in cardiac surgery. The management of HIT patients undergoing cardiac surgery with cardiopulmonary bypass is complex and requires an interdisciplinary and patient-tailored approach because available evidence is limited and current anticoagulation strategies have potential risks. An index case is used to discuss both the established and new perioperative therapeutic options in HIT patients undergoing urgent cardiac surgery with cardiopulmonary bypass. (C) 2020 Elsevier Inc. All rights reserved.

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