American Society of Hirudotherapy

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

Case report published in Portuguese Journal of Cardiac Thoracic and Vascular Surgery (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportDrug DevelopmentAlves B et al. · Portuguese Journal of Cardiac Thoracic and Vascular Surgery, 2025

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.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleCase Reports
Indexed MeSH termsHumansAnticoagulantsAntithrombinsHeart Valve Prosthesis ImplantationHeparinHirudinsMitral Valve InsufficiencyPeptide FragmentsRecombinant ProteinsReoperationShock, CardiogenicThrombocytopenia

Summary

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

Why This Matters for Hirudotherapy

This case report describes a patient with heparin-induced thrombocytopenia (HIT) and cardiogenic shock who received bivalirudin during the perioperative period of an urgent reoperation for recurrent mitral valve dysfunction, with a reportedly safe outcome under institutional protocols. The abstract discusses bivalirudin as an alternative to heparin in the perioperative setting but provides no detail on its mechanism beyond clinical use. For ASH, no defensible leech or hirudotherapy connection exists from the abstract: it does not mention leeches, hirudin, or leech-derived therapy. Honest caveat: this is a single case report involving no leeches or leech therapy, and it does not establish efficacy or safety beyond the described individual.

Citation

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

Alves B et al. · Portuguese Journal of Cardiac Thoracic and Vascular Surgery, 2025

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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