1 2011 European Association for Cardio-thoracic Surgery doi:10.1510/mmcts.2010.004481 Strategies in heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia (HIT) is an uncommon condition that may confront car-dio-thoracic surgeons with difficult problems. The underlying cause of HIT is the formation of antibodies against platelet factor 4/heparin complexes, leading to platelet activation and intravascular platelet aggregation. HIT occurs following heparin administration usually with a time delay of 5–10 days. Clinical suspicion and laboratory tests for platelet-activating antibodies are the cornerstone of diagnosis. Appropriate strategies in HIT are stopping hepa-rin and use of alternative anticoagulants. In addition, surgery with extracorporeal circulation (ECC) should be postponed whenever possible or alternative anticoagulants have to be used during ECC