title: Favorable outcome with bivalirudin anticoagulation during cardiopulmonary bypass.
abstract: An 81-year-old man with previous syncopal episodes, progressive shortness of breath, pulmonary edema, severe calcific aortic stenosis, and a history of heparin-induced thrombocytopenia required aortic valve replacement. Bivalirudin, a thrombin-specific anticoagulant, was used in place of heparin. The patient received a 50 mg bivalirudin bolus followed by an infusion between 1.5 mg x kg(-1) x h(-1) and 1.75 mg x kg(-1) x h(-1). Adequate anticoagulation was readily obtained resulting in an uneventful cardiopulmonary bypass. Activated clotting time (ACT) values steadily declined after discontinuation of the bivalirudin infusion. Bivalirudin is a practical alternative to heparin during cardiac surgical procedures.
authors.affiliation: Edward Hospital, Naperville, Illinois, USA. zdavis@openheart.net
authors.forename: Zev
authors.initials: Z
authors.lastname: Davis
authors.forename: Richard
authors.initials: R
authors.lastname: Anderson
authors.forename: Daniel
authors.initials: D
authors.lastname: Short
authors.forename: David
authors.initials: D
authors.lastname: Garber
authors.forename: Araldo
authors.initials: A
authors.lastname: Valgiusti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006350:Heart Valve Prosthesis; D006629:Hirudins / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D014914:Whole Blood Coagulation Time
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin