Bivalirudin use in off-pump myocardial revascularization in patients with heparin-induced thrombocytopenia [corrected].
With advances in therapy of acute coronary syndromes, repetitive exposure to heparin has become commonplace. Consequently, the incidence of heparin-induced thrombocytopenia has risen. Limited strategies for management exist, and new thrombin inhibitors may provide safe alternatives to heparin. Two patients with documented heparin-induced thrombocytopenia underwent revascularization using a new thrombin inhibitor (Bivalirudin [Angiomax, Medicines Co, Cambridge, MA]) for anticoagulation. Both patients had uneventful perioperative hospitalizations. Thrombin inhibition with Bivalirudin (Angiomax) may provide a safe reliable alternative to heparin use in cardiac surgery [corrected].
Bott
Jeffrey N
JN
Department of Cardiovascular Surgery, Orlando, Florida 32809, USA. jbott@cvsorlando.com
Reddy
Karan
K
Krick
Stacie
S
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006355:Heart-Lung Machine; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006629:Hirudins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000188:drug therapy*; D009204:Myocardial Revascularization / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000503:physiopathology; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D006629:Hirudins; D006493:Heparin