American Society of Hirudotherapy

Bivalirudin Anticoagulation for a Pediatric Patient with Heparin-Induced Thrombocytopenia and Thrombosis Requiring Cardiopulmonary Bypass for Ventricular Assist Device Placement

Case report published in J Extra Corpor Technol (2016)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportDrug DevelopmentClinical TrialsFaella KH et al. · The journal of extra-corporeal technology, 2016

Abstract

The direct thrombin inhibitor bivalirudin is an option for anticoagulation in patients with heparin induced thrombocytopenia (HIT) requiring cardiopulmonary bypass (CPB). There are a limited number of reports of pediatric patients in which bivalirudin has been used for anticoagulation for CPB. We present the case of an 11 year old male with acute onset heart failure secondary to idiopathic dilated cardiomyopathy that developed heparin induced thrombocytopenia with thrombosis (HITT). The patient was anticoagulated in the operating room with bivalirudin and placed on CPB for insertion of a HeartWare(®) Ventricular Assist Device (Heartware(®)). Modified techniques were utilized. This included use of the Terumo CDI 500 (Terumo Cardiovascular Systems, Inc.) in-line blood gas monitor which contains a heparin coated arterial shunt sensor. We flushed this sensor with buffered saline preoperatively and noted no significant decrease in platelet count postoperatively. The patient was successfully placed on the ventricular assist device and was subsequently listed for heart transplantation.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAnticoagulantsCardiomyopathy, DilatedCardiopulmonary BypassChildHeart FailureHeart TransplantationHeart-Assist DevicesHeparinHirudinsHumansMalePeptide Fragments

Summary

11-year-old male with idiopathic dilated cardiomyopathy and HITT successfully anticoagulated with bivalirudin during CPB for HeartWare VAD insertion using modified technique with buffered saline flush.

Why This Matters for Hirudotherapy

This case report describes an 11-year-old boy with idiopathic dilated cardiomyopathy who developed heparin-induced thrombocytopenia with thrombosis (HITT) and was anticoagulated with bivalirudin during cardiopulmonary bypass for HeartWare VAD insertion. The abstract notes modified techniques, including flushing a heparin-coated arterial sensor with buffered saline, with no significant postoperative platelet drop, and successful device placement with subsequent transplant listing. No defensible connection to hirudotherapy, leech therapy, or the leech secretome exists based on this abstract, which identifies bivalirudin only as a direct thrombin inhibitor without any mention of hirudin, leeches, or derivation thereof. As a single case, the findings are not generalizable, and the abstract notes the limited number of pediatric reports in this area.

Citation

Bivalirudin Anticoagulation for a Pediatric Patient with Heparin-Induced Thrombocytopenia and Thrombosis Requiring Cardiopulmonary Bypass for Ventricular Assist Device Placement.

Faella KH et al. · The journal of extra-corporeal technology, 2016

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

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