Early onset of heparin-induced thrombocytopenia with thrombosis after open heart surgery: importance of an early diagnosis and Lepirudin treatment
Paparella, D.; Galeone, A.; Micelli, M.; Memmola, C.; de Luca Tupputi Schinosa, L.
Blood Coagulation and Fibrinolysis An International Journal in Haemostasis and Thrombosis 15(2): 183-185
2004
ISSN/ISBN: 0957-5235 PMID: 15091006 Document Number: 576011
Heparin-induced thrombocytopenia with thrombosis (HITT) is a rare complication of cardiac surgery with cardiopulmonary bypass. We report two cases of HITT treated with the direct thrombin inhibitor Lepirudin. Immediate diagnosis was essential to prompt heparin discontinuation and successful early Lepirudin administration in the first case. In the second, the presence of an intro-aortic balloon pump delayed HITT recognition, and Lepirudin infusion could not prevent limb amputation. In both cases HITT occurred earlier (< 5 days after heparin exposure) than its usual presentation. Copyright 2004 Lippincott Williams & Wilkins.