Key result
Bivalirudin dose uptitration was required during cardiac catheterization in a 4-year-old patient with complex congenital heart disease and heparin-induced thrombocytopenia.
Why the study?
While bivalirudin safety and efficacy are well described in adults, its use in pediatric populations is relatively rare with dosing extrapolated from adult data.
Case Report (n=1)
This case report highlights the potential need for bivalirudin dose uptitration when used as a procedural anticoagulant in pediatric patients undergoing cardiac catheterization.
Supports bivalirudin feasibility in select pediatric CHD cases; leaves open need for dedicated dosing and safety trials.
Bivalirudin is a direct thrombin inhibitor that is used as a procedural anticoagulant during percutaneous coronary interventions and cardiac surgery for patients with heparin-resistant thrombosis or heparin-induced thrombocytopenia. There is a robust literature describing its safety and efficacy in adults; however, its use in the pediatric population is relatively rare, with dosing extrapolated from adult data. In this case report, we describe a 4-year-old with complex congenital heart disease and history of heparin-induced thrombocytopenia who required bivalirudin dose uptitration during cardiac catheterization.
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Streiff et al. (2019) conducted a case report in Complex congenital heart disease and heparin-induced thrombocytopenia (n=1). Bivalirudin was evaluated. Bivalirudin dose uptitration was required during cardiac catheterization in a 4-year-old patient with complex congenital heart disease and heparin-induced thrombocytopenia.
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