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 cardi ac surgeon. In this review, I-he clinical and experimental experience descr ibed in the literature are discussed in the perspective of the normal coagu lation 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.