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New research · Anesthesiology
The Journal of thoracic and cardiovascular surgery · 1d
GuidelineThe Journal of thoracic and cardiovascular surgery · 2026

2026 American Association for Thoracic Surgery Expert Consensus Document: Diagnosis and management of heparin-induced thrombocytopenia in patients who undergo cardiac surgery.

Subhasis Chatterjee, Natalia I Girardi, Jessica Crow … Daniel T Engelman
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AnesthesiologyGuideline

Expert panel developed 32 recommendations for heparin-induced thrombocytopenia management.

2026 American Association for Thoracic Surgery Expert Consensus Document: Diagnosis and management of heparin-induced thrombocytopenia in patients who undergo cardiac surgery.

Subhasis Chatterjee et al. · The Journal of thoracic and cardiovascular surgery · 2026
Background

Heparin-induced thrombocytopenia (HIT) in patients who undergo cardiac surgery presents unique diagnostic and management challenges due to universal perioperative heparin exposure, postoperative platelet kinetics, and the high prevalence of critical illness in this population.

Purpose

By addressing the complexities unique to cardiac surgery, high-risk anticoagulation environments, and extracorporeal and temporary mechanical circulatory support, these recommendations aim to improve diagnostic accuracy, standardize care, reduce complications, and support safe heparin re-exposure or alternative anticoagulation strategies when surgery is required.

Methods

Using a modified Delphi methodology, the panel evaluated the evidence, developed clinical statements, and assigned a class of recommendation and a level of evidence to each recommendation.

Results
recommendations
recommendations for managing a serious blood clotting problem caused by a blood thinner
More results

Additional best practices are included for cardiopulmonary bypass circuit management for patients with HIT.

“
Conclusion

This American Association for Thoracic Surgery Expert Consensus Document provides practical, cardiac surgery-specific guidance for the diagnosis and management of HIT across the continuum of cardiac surgical care.

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