Patients with subacute HIT B or a documented remote history of HIT who face cardiovascular surgery represent a distinct clinical challenge. The phase of HIT and the unavoidable anticoagulation demands of surgery intersect in ways that require a carefully defined, time-limited approach.
This protocol addresses patients with subacute HIT B or remote HIT who have an indication for cardiovascular surgery — a situation where the timing of HIT relative to surgery directly shapes anticoagulant decision-making.
Management involves a specific intraoperative anticoagulation strategy, with strict restrictions on anticoagulant choice outside the operative window. The full protocol details the recommended approach, the alternatives considered by the guideline panel, and the reasoning behind perioperative timing restrictions.