Cardiopulmonary bypass in patients with heparin-induced thrombocytopenia and thrombosis

Heparin-induced thrombocytopenia and thrombosis (HITT) is an immunomediated disorder induced by the administration of heparin for therapeutic purposes. The presence of this condition in patients requiring full heparinization for cardiopulmonary bypass constitutes a formidable challenge for the cardiac surgeon. In this review, I-he clinical and experimental experience described in the literature are discussed in the perspective of the normal coagulation and the pathophysiology of HITT and in the light of a variety of old and new alternative anticoagulants. (Ann Thorac Surg 2000;70:2173-81) (C) 2000 by The Society of Thoracic Surgeons.