{"title":"An impetuous \"HIT\"-sudden blockage of all grafts post CABG.","authors":"Jaytesh Parashar, Ganesh Shivnani, Sumir Dubey, Bhupender Singh Bisht, Nadeem Saifi","doi":"10.1007/s12055-024-01839-x","DOIUrl":null,"url":null,"abstract":"<p><p>We report a case of hyperacute multiple graft thrombosis following an uneventful coronary artery bypass graft (CABG) surgery in a 69-year-old female with chronic immune thrombocytopenia (ITP). Detailed evaluation revealed the presence of anti-PF4/heparin antibodies, confirming the diagnosis of heparin-induced thrombocytopenia (HIT). The co-existence of chronic ITP masked the thrombocytopenia typically associated with HIT, complicating the recognition of the thrombotic and hematologic abnormalities. This case emphasizes the importance of promptly discontinuing heparin when HIT is suspected or confirmed. Additionally, maintaining a low threshold for suspecting HIT in patients with ITP undergoing cardiac surgery is crucial, as this complex interplay may increase the risk of severe postoperative complications.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"486-489"},"PeriodicalIF":0.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933507/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Thoracic and Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12055-024-01839-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/19 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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Abstract
We report a case of hyperacute multiple graft thrombosis following an uneventful coronary artery bypass graft (CABG) surgery in a 69-year-old female with chronic immune thrombocytopenia (ITP). Detailed evaluation revealed the presence of anti-PF4/heparin antibodies, confirming the diagnosis of heparin-induced thrombocytopenia (HIT). The co-existence of chronic ITP masked the thrombocytopenia typically associated with HIT, complicating the recognition of the thrombotic and hematologic abnormalities. This case emphasizes the importance of promptly discontinuing heparin when HIT is suspected or confirmed. Additionally, maintaining a low threshold for suspecting HIT in patients with ITP undergoing cardiac surgery is crucial, as this complex interplay may increase the risk of severe postoperative complications.
期刊介绍：
The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.
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