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Cardiopulmonary bypass with bivalirudin in type II heparin-induced thrombocytopenia |
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| Authors: | Clayton Stephanie B Acsell Jeffrey R Crumbley Arthur J Uber Walter E |
| Affiliation: | aDepartment of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA bDepartment of Cardiovascular Perfusion, Medical University of South Carolina, Charleston, South Carolina, USA cDepartment of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA |
| Abstract: | Cardiopulmonary bypass in patients with type II heparin induced-thrombocytopenia poses significant challenges. Inadequate pharmacokinetic profiles, monitoring, reversibility, and availability often limit alternative anticoagulation strategies. Bivalirudin, a semisynthetic direct thrombin inhibitor, was recently approved for use in patients undergoing percutaneous coronary interventions. Its unique properties, including a relatively short half-life, an anticoagulation effect that closely correlates with activated clotting time, and an alternate metabolic pathway for elimination, make bivalirudin an attractive agent for cardiopulmonary bypass in patients with type II heparin induced-thrombocytopenia. We report our experience using bivalirudin in 2 patients undergoing coronary artery bypass grafting. |
| Keywords: | 25 |
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