Acute heparin-induced thrombocytopenia (HIT) without thrombocytopenia post aortocoronary bypass grafting

Abstract

Heparin-induced thrombocytopenia (HIT) after cardiac surgery is a clinical condition associated with increased incidence of thromboembolic events and mortality. HIT without thrombocytopenia is a rare clinical entity poorly reported in the literature, especially after cardiac surgery. In this case report, we present the case of a post aortocoronary bypass grafting patient who presented with HIT in the absence of thrombocytopenia.

Keywords: Anti-heparin antibody; Graft thrombosis; HIT without thrombocytopenia; Heparin-induced thrombocytopenia.

Fig. 1

A Initial coronary angiography during ST elevation. On the left, the first mid of the right coronary artery is patent and then is totally occluded on antegrade perfusion. B A thin catheter is forwarded to the posterior descending artery. The right internal mammary is still patent (presence of contrast) with perfusion of the posterior descending artery but the flow is obstructed proximally to anastomosis (green arrow)

Fig. 2

A Depiction of the right mammary artery on antegrade perfusion from the right subclavian artery. B The course of the right mammary artery is indicated by contrast presence. C Two stents are placed in the right coronary artery and the pedicled right internal mammary is patent (orange arrow)