[HSF] HIT and CPB

[Anoop Ganjoo]

We once used a heparin bonded circuit (Carmeda Bioactive Surface) for
CPB, along with systemic enoxaparin for an on-pump CABG in a pt. with
HIT. (J Thorac Cardiovasc Surg 1996;112:1390-2). On another occasion
we used the heparinoid Orgaran for anticoagulation for CPB. (J
Cardiothorac Vasc Anesth 1997;11:262-4). Both patients did well.

Since both LMWHs and heparinoids are known to have cross-reactivity
with standard heparin, it is important to test the pt.'s plasma for
reaction with the agent being considered for use. Also, in case of
excessive postop. drainage, one
can try plasmapheresis if blood product transfusions and correction of
any associated coagulopathies does not help.

Anoop Ganjoo
Apollo Hospital
New Delhi, India
On 5/31/07, Tea Acuff <tacuff at swbell.net> wrote:
> I know we have discussed this before, but anyone have recent experience with preop HIT and need for CPB. Unfortunately this patient is a 50ish redo (operated age 9) with bicuspid aortic valve and dilated aorta mild MR and TR normal coronaries. I was unable to find our discussion in HSF. Will check my own emails (over 12000 messages!). I think my last thought on the subject theoretically was that would be a good case to refer to an expert if I could find one. Suggestions?
> tea
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