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Successful use of bivalirudin for cardiopulmonary bypass in a patient with heparin allergy

F. Pappalardo

Department of Cardiovascular Anesthesia and Intensive Care, San Raffaele Hospital, Milan, Italy, pappalardo.federico{at}hsr.it

A. Franco

Department of Cardiovascular Anesthesia and Intensive Care, San Raffaele Hospital, Milan, Italy

G. Crescenzi G

Department of Cardiovascular Anesthesia and Intensive Care, San Raffaele Hospital, Milan, Italy

A. Poli

Department of Cardiovascular Anesthesia and Intensive Care, San Raffaele Hospital, Milan, Italy

A. Zangrillo

Department of Cardiovascular Anesthesia and Intensive Care, San Raffaele Hospital, Milan, Italy

A. Koster

Department of Anesthesiology, Deutsches Herzzentrum Berlin, Berlin, Germany

Heparin-induced IgE-mediated hypersensitivity and anaphylactoid reactions, although rare, can pose a serious clinical problem for patients requiring cardiopulmonary bypass (CPB). Bivalirudin is a bivalent reversible direct thrombin inhibitor, with a half-life of 25 min, eliminated mostly by proteolytic cleavage. There are some reports on the use of bivalirudin for cardiac surgery, particularly for heparin-induced thrombocytopenia (HIT), but none on cases of heparin allergy. We report a case of heparin allergy successfully managed for CPB with bivalirudin anticoagulation. Perfusion (2007) 22, 67-69.

Perfusion, Vol. 22, No. 1, 67-69 (2007)
DOI: 10.1177/0267659106076004
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