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Ann Thorac Surg 2003;75:264-265
© 2003 The Society of Thoracic Surgeons

Case report

Favorable outcome with bivalirudin anticoagulation during cardiopulmonary bypass

Zev Davis, MD*a, Richard Anderson, MDa, Daniel Short, MDa, David Garber, PA-Ca, Araldo Valgiusti, CCPa

a Edward Hospital, Naperville, Illinois, USA

Accepted for publication August 14, 2002.

* Address reprint requests to Dr Davis, Cardiac Surgery Associates, 120 Spalding Dr, Suite 209, Naperville, IL 60540, USA
e-mail: zdavis{at}openheart.net

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 · kg-1 · h-1 and 1.75 mg · kg-1 · 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.




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