Heparin Induced Thrombocytopenia In The Setting Of Urgent Cardiac Surgery: Can Bivalirudin Be A Safe Option? – A Case Report

• Author(s): Alves, Bárbara ; Veiga, Joana ; Morais, Inês ; Lima, Fátima ; Paulo, Nelson
• Date: 2025
• Origin: Portuguese Journal of Cardiac Thoracic and Vascular Surgery
• Subject(s): bivalirudin; heparin; thrombocytopenia; cardiac surgical procedure
• Document Type: Journal article
• Language: English

Description

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.