CORONARY-ARTERY BYPASS-GRAFTING IN A PATIENT WITH TYPE-II HEPARIN-ASSOCIATED THROMBOPENIA

Two types of heparin-associated thrombopenia can be distinguished. Pat ients with the type II condition present a particularly difficult mana gement problem when they require full anticoagulation. There is no con sensus about the proper anticoagulation management for type II patient s who have to undergo cardiopulmonary bypass. The case is reported of a type II heparin-associated thrombopenia patient who underwent succes sful aortocoronary saphenous vein grafting. Sodium-danaparoid was used for anticoagulation. The anti-factor Xa level was kept below the valu e reported in the literature for patients undergoing cardiopulmonary b ypass. No fibrin formation was observed during the time of cardiopulmo nary bypass, nor was any severe postoperative haemorrhage seen, as is frequently described in the literature. (C) 1998 The International Soc iety for Cardiovascular Surgery.