Heparin-induced thrombocytopenia (HIT) occurs in both the pediatric and adult populations after exposure to heparin. Bivalirudin has been used as an alternative to heparin for adults undergoing cardiac surgery and cardiopulmonary bypass, but has only been used minimally in children for this purpose. We report the successful use of bivalirudin for anticoagulation during cardiopulmonary bypass in a small child with HIT, using novel techniques not previously described.
AlmondCHarringtonJThiagarajanR. Successful use of bilavilirudin for cardiac transplantation in a child with heparin-induced thrombocytopenia. J Heart Lung Transplant2006; 25: 1376–1379.
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GatesRYostPParkerB. The use of bivalirudin for cardiopulmonary bypass anticoagulation in pediatric heparin-induced thrombocytopenia patients. Artif Organs2010; 34: 667–669.
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KosterABuzSKrabatschTYeterRHetzerR. Bivalirudin anticoagulation during cardiac surgery: a single-center experience in 141 patients. Perfusion2009; 24: 7–11.
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KosterAYeterRBuzS. Assessment of hemostatic activation during cardiopulmonary bypass for coronary artery bypass grafting with bivalirudin: results of a pilot study. J Thorac Cardiovasc Surg2005; 129: 1391–1394.
