Case Reports

Use of Bivalirudin for Anticoagulation during Implantation of Total Artificial Heart

Address correspondence to: Myke Federman, MD, Assistant Professor, Pediatrics, Mattel Children’s Hospital UCLA, 10833 LeConte Avenue, 12-494 MDCC, Los Angeles, CA 90095. E-mail: mfederman@mednet.ucla.edu

Received: 23 January 2014
Accepted: 18 April 2014

Abstract

Heparin-induced thrombocytopenia presents a challenge for anticoagulation techniques during cardiac surgery and ventricular assist device implantation. Bivalirudin is currently recommended for use during cardiopulmonary bypass for patients with heparin-induced thrombocytopenia but requires the use of special techniques to avoid blood stagnation. We report the successful use of bivalirudin during cardiopulmonary bypass for implantation of the Total Artificial Heart with late operative bleeding likely resulting from heavy cell saver use.