Key result
Bivalirudin provides effective bypass anticoagulation for LVAD placement and heart transplantation in adolescent HIT.
Why the study?
Does bivalirudin provide safe and effective anticoagulation during cardiopulmonary bypass in a pediatric patient with HIT?
Case Report (n=1)
No
Does bivalirudin provide safe and effective anticoagulation during cardiopulmonary bypass in a pediatric patient with HIT?
Bivalirudin can serve as an effective alternative anticoagulant during cardiopulmonary bypass for complex cardiac surgeries in pediatric patients with HIT.
Bivalirudin may support anticoagulation during CPB in adolescents with HIT; leaves open need for prospective data before broader adoption.
Heparin-induced thrombocytopenia (HIT) can cause life-threatening complications following the administration of heparin. Discontinuation of all sources of heparin exposure and the use of alternative agents for anticoagulation are necessary when HIT is suspected or diagnosed. We present the successful use of bivalirudin anticoagulation in an adolescent patient during cardiopulmonary bypass who underwent both placement of a left ventricular assist device and subsequent heart transplantation within a 36-hour period. The pathophysiology and diagnosis of HIT are reviewed, previous reports of the use of direct thrombin inhibitors for cardiac surgery are presented, and potential dosing regimens for bivalirudin are discussed.
No takes yet. Share an insight, caveat, or question.
Kamata et al. (2017) conducted a case report in Heparin-induced thrombocytopenia (HIT) and dilated cardiomyopathy (n=1). Bivalirudin was evaluated on Successful anticoagulation and surgical outcome. Bivalirudin successfully provided effective anticoagulation during cardiopulmonary bypass for both LVAD placement and subsequent heart transplantation in an adolescent with HIT.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: