Bivalirudin anticoagulation for a patient with hypercoagulable immune syndromes undergoing mitral valve surgery
| Autor: | Mark H. Nelson, Harry L. McCarthy, Bruce D. Spiess, Rebecca L. Cain, Abe Deanda, Jeffrey A. Green |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult medicine.medical_specialty medicine.drug_class Hypertension Pulmonary Cross Reactions Platelet Factor 4 law.invention law Antiphospholipid syndrome Antibody Specificity Renal Dialysis Heparin-induced thrombocytopenia Internal medicine medicine Cardiopulmonary bypass Bivalirudin Humans Lupus Erythematosus Systemic Thrombophilia Autoantibodies Heart Failure business.industry Heparin Platelet Count Anticoagulant Anticoagulants Mitral Valve Insufficiency Hirudins medicine.disease Antiphospholipid Syndrome Thrombocytopenia Peptide Fragments Recombinant Proteins Cardiac surgery Surgery Direct thrombin inhibitor Cardiology Drug Evaluation Kidney Failure Chronic Drug Therapy Combination Female Warfarin Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The Annals of thoracic surgery. 81(6) |
| ISSN: | 1552-6259 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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