Bivalirudin Anticoagulation for a Pediatric Patient with Heparin-Induced Thrombocytopenia and Thrombosis Requiring Cardiopulmonary Bypass for Ventricular Assist Device Placement

11-year-old male with acute onset heart failure secondary to idiopathic dilated cardiomyopathy who developed heparin-induced thrombocytopenia with thrombosis (HITT) (n=1).

Bivalirudin anticoagulation (50 mg prime bolus, 60 mg bolus before bypass, and 2.5-5.0 mg/kg/h infusion) during cardiopulmonary bypass for HeartWare Ventricular Assist Device placement, utilizing modified techniques including a heparin-coated Terumo CDI 500 in-line blood gas monitor flushed with buffered saline.

Successful placement of the ventricular assist device and maintenance of postoperative platelet counts.safety