Bivalirudin anticoagulation for a patient with hypercoagulable immune syndromes undergoing mitral valve surgery.
Ann Thorac Surg
; 81(6): 2308-10, 2006 Jun.
Article
en En
| MEDLINE
| ID: mdl-16731183
ABSTRACT
Unfractionated heparin has been a near universal anticoagulant for cardiac surgery; however it is contraindicated in heparin-induced thrombocytopenia type II. Alternative anticoagulants such as bivalirudin (a direct thrombin inhibitor) are being utilized. Bivalirudin was successfully used in an immunologically complex patient (diagnoses of heparin-induced thrombocytopenia type II, systemic lupus erythematosus, antiphospholipid syndrome, and dialysis-dependent renal failure) requiring cardiopulmonary bypass. Thrombotic events are common in antiphospholipid syndrome patients undergoing cardiac surgery utilizing high-dose heparin. This may represent unrecognized heparin-induced thrombocytopenia type II. Our patient did not experience perioperative thrombotic or bleeding complications. The possible cross-reactivity between heparin induced thrombocytopenia type II and antiphospholipid syndrome has not been investigated.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Fragmentos de Péptidos
/
Autoanticuerpos
/
Trombocitopenia
/
Heparina
/
Síndrome Antifosfolípido
/
Trombofilia
/
Lupus Eritematoso Sistémico
/
Insuficiencia de la Válvula Mitral
/
Anticoagulantes
Tipo de estudio:
Etiology_studies
Límite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Ann Thorac Surg
Año:
2006
Tipo del documento:
Article
País de afiliación:
Estados Unidos