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

Rebecca L. Cain, Bruce D. Spiess, Mark Nelson, Abe Deanda, Harry L. McCarthy, Jeffrey A. Green

Research output: Contribution to journalArticle

8 Scopus citations


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
Issue number6
StatePublished - Jun 1 2006
Externally publishedYes


ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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