Publication Date
12-1-2014
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-13-3631
PMID
25593533
Publication Date(s)
December 2014
Language
English
PMCID
PMC4251340
PubMedCentral® Posted Date
12-1-2014
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Anticoagulants/adverse effects, aortic dissection, bivalirudin, blood coagulation, blood loss, surgical, cardiopulmonary bypass, circulatory arrest, deep hypothermia induced, hemofiltration, heparin/adverse effects, hirudins, thrombocytopenia/chemically induced/prevention & control
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
Heparin-induced thrombocytopenia is a well-recognized complication of anticoagulation with heparin. We present the case of a patient with recent heparin-induced thrombocytopenia who subsequently needed surgery on an emergency basis for acute type A aortic dissection. This article reports the successful use of bivalirudin, a direct thrombin inhibitor, as an alternative to heparin throughout cardiopulmonary bypass and deep hypothermic circulatory arrest. We contend that bivalirudin is a safe alternative to heparin when performing surgery for aortic dissection and should be considered as an option for use in patients who present with heparin-induced thrombocytopenia.