Bárbara Alves, Joana Veiga, Inês Morais, Fátima Lima, Nelson Paulo
{"title":"Heparin Induced Thrombocytopenia In The Setting Of Urgent Cardiac Surgery: Can Bivalirudin Be A Safe Option? - A Case Report.","authors":"Bárbara Alves, Joana Veiga, Inês Morais, Fátima Lima, Nelson Paulo","doi":"10.48729/pjctvs.448","DOIUrl":null,"url":null,"abstract":"<p><p>Unfractionated heparin is the main anticoagulant employed in the context of cardiovascular surgery. When a patient with heparin induced thrombocytopenia (HIT) is proposed for cardiac surgery, the anticoagulation management is challenging. Bivalirudin is an alternative to heparin in the perioperative setting. We present a rare case of a patient with HIT and cardiogenic shock that required bivalirudin use in the perioperative period of an urgent reoperation of recurrent mitral valve dysfunction. Although infrequent, the use of bivalirudin can be safe in high risk patients if adequate measures follow institutional protocols, as reported in this case.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 1","pages":"55-58"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Portuguese journal of cardiac thoracic and vascular surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.48729/pjctvs.448","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Unfractionated heparin is the main anticoagulant employed in the context of cardiovascular surgery. When a patient with heparin induced thrombocytopenia (HIT) is proposed for cardiac surgery, the anticoagulation management is challenging. Bivalirudin is an alternative to heparin in the perioperative setting. We present a rare case of a patient with HIT and cardiogenic shock that required bivalirudin use in the perioperative period of an urgent reoperation of recurrent mitral valve dysfunction. Although infrequent, the use of bivalirudin can be safe in high risk patients if adequate measures follow institutional protocols, as reported in this case.