Abstract
A 71-year-old woman who had rheumatoid arthritis, chronic kidney disease (CKD) and peripheral artery disease had acute myocardial infarction due to three-vessel coronary artery disease and was transferred to a hospital. After anticoagulation was achieved with continuous intravenous infusion of heparin, her platelet count decreased, and a definitive diagnosis of heparin-induced thrombocytopenia (HIT) type II was made by a serologic test confirming positive antibodies to the heparin-platelet factor 4 (PF4) complexes. Furthermore, CKD was getting worse because of the contrast media and hemodialysis was needed three times a week, in addition to having vein thrombosis. Then she was transferred to our hospital for surgery, and we performed an off-pump coronary artery bypass (OPCAB) using argatroban as an alternative anticoagulant. The postoperative course was uneventful and platelet count returned to normal. We report a case of HIT that successfully underwent OPCAB using argatroban.
