Abstract
Heparin-induced thrombocytopenia (HIT) is a rare but potentially devastating and life-threatening complication from using heparin. HIT not only causes thrombocytopenia, but it also carries an increased risk for fatal thrombotic complications. In this report, we describe the case of a patient in whom fatal HIT developed after successful surgical repair of a posterior post-infarction ventricular septal rupture with cardiopulmonary bypass.
Highlights
Heparin-induced thrombocytopenia (HIT) is a rare but potentially devastating and life-threatening complication from using heparin
We describe the case of a patient in whom fatal HIT developed after successful surgical repair of a posterior post-infarction ventricular septal rupture with cardiopulmonary bypass
We describe the case of a patient in whom fatal HIT developed after successful surgical repair of a posterior Post-infarction ventricular septal rupture (PI-VSR) on cardiopulmonary bypass (CPB)
Summary
A 74-year-old man presented with chest pain to a local hospital, from where he was transferred to our institution, with a PI-VSR He had been anticoagulated with unfractioned heparin (UFH) (1 000 IU/h daily) for three days since the myocardial infarction (MI) had occurred. CABG was performed with sequential grafting of the saphenous vein to the left anterior descending artery and second diagonal branch. For 48 hours during the immediate postoperative period, the patient was managed with intra-aortic balloon counter pulsation and small doses of inotropic drugs. He was weaned off IABP on the third postoperative day. The nadir platelet count was 25 × 103 cells/μl on the seventh postoperative day (Fig. 2).
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