Bivalirudin Anticoagulation for a Patient with Hypercoagulable Immune Syndromes Undergoing Mitral Valve Surgery

Rebecca L. Cain, Bruce D. Spiess, Mark Nelson, Abelardo DeAnda, Harry L. McCarthy, Jeffrey A. Green

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Unfractionated heparin has been a near universal anticoagulant for cardiac surgery; however it is contraindicated in heparin-induced thrombocytopenia type II. Alternative anticoagulants such as bivalirudin (a direct thrombin inhibitor) are being utilized. Bivalirudin was successfully used in an immunologically complex patient (diagnoses of heparin-induced thrombocytopenia type II, systemic lupus erythematosus, antiphospholipid syndrome, and dialysis-dependent renal failure) requiring cardiopulmonary bypass. Thrombotic events are common in antiphospholipid syndrome patients undergoing cardiac surgery utilizing high-dose heparin. This may represent unrecognized heparin-induced thrombocytopenia type II. Our patient did not experience perioperative thrombotic or bleeding complications. The possible cross-reactivity between heparin induced thrombocytopenia type II and antiphospholipid syndrome has not been investigated.

Original languageEnglish (US)
Pages (from-to)2308-2310
Number of pages3
JournalAnnals of Thoracic Surgery
Volume81
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

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Mitral Valve
Heparin
Thrombocytopenia
Antiphospholipid Syndrome
Anticoagulants
Thoracic Surgery
Antithrombins
Cardiopulmonary Bypass
Systemic Lupus Erythematosus
Renal Insufficiency
bivalirudin
Dialysis
Hemorrhage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Bivalirudin Anticoagulation for a Patient with Hypercoagulable Immune Syndromes Undergoing Mitral Valve Surgery. / Cain, Rebecca L.; Spiess, Bruce D.; Nelson, Mark; DeAnda, Abelardo; McCarthy, Harry L.; Green, Jeffrey A.

In: Annals of Thoracic Surgery, Vol. 81, No. 6, 06.2006, p. 2308-2310.

Research output: Contribution to journalArticle

Cain, Rebecca L. ; Spiess, Bruce D. ; Nelson, Mark ; DeAnda, Abelardo ; McCarthy, Harry L. ; Green, Jeffrey A. / Bivalirudin Anticoagulation for a Patient with Hypercoagulable Immune Syndromes Undergoing Mitral Valve Surgery. In: Annals of Thoracic Surgery. 2006 ; Vol. 81, No. 6. pp. 2308-2310.
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