title: Bivalirudin anticoagulation for cardiopulmonary bypass: an unusual case.
abstract: The standard agent used for systemic anticoagulation during cardiopulmonary bypass is heparin. Alternative methods of anticoagulation are required for patients with heparin hypersensitivity. We present the case of a patient with heparin hypersensitivity who was anticoagulated with bivalirudin during cardiopulmonary bypass for coronary artery bypass grafting. This presented unusual challenges surrounding the monitoring of anticoagulation and the method of myocardial protection.
authors.affiliation: Department of Cardiothoracic Surgery, Wessex Cardiothoracic Centre, Southampton General Hospital, Southampton SO16 6YD, United Kingdom.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Nikolaidis
authors.forename: Theodore
authors.initials: T
authors.lastname: Velissaris
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Ohri
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy; D004342:Drug Hypersensitivity / Q000209:etiology; D006493:Heparin / Q000009:adverse effects; D006629:Hirudins; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy; D010446:Peptide Fragments / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000628:therapy; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin