American Society of Hirudotherapy

Titration of Bivalirudin Infusion in the Pediatric Cardiac Catheterization Laboratory: A Case Report

Case report published in A&A Pract (2019)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportDrug DevelopmentClinical TrialsStreiff A et al. · A&A practice, 2019

Abstract

Bivalirudin is a direct thrombin inhibitor that is used as a procedural anticoagulant during percutaneous coronary interventions and cardiac surgery for patients with heparin-resistant thrombosis or heparin-induced thrombocytopenia. There is a robust literature describing its safety and efficacy in adults; however, its use in the pediatric population is relatively rare, with dosing extrapolated from adult data. In this case report, we describe a 4-year-old with complex congenital heart disease and history of heparin-induced thrombocytopenia who required bivalirudin dose uptitration during cardiac catheterization.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAntithrombinsCardiac CatheterizationChild, PreschoolHeart DiseasesHirudinsHumansMalePeptide FragmentsRecombinant ProteinsTreatment Outcome

Summary

Case report of 4-year-old with complex congenital heart disease and HIT requiring bivalirudin uptitration during cardiac catheterization with successful procedural completion.

Why This Matters for Hirudotherapy

This case report describes a 4-year-old patient with complex congenital heart disease and a history of heparin-induced thrombocytopenia who required bivalirudin dose uptitration during cardiac catheterization. The abstract notes the paucity of pediatric literature and that dosing is largely extrapolated from adult data. The abstract describes bivalirudin as a direct thrombin inhibitor but does not mention hirudin, leeches, or any leech-derived compound, so no defensible hirudotherapy link exists. This is a single case report involving one patient, does not involve leeches or hirudotherapy, and provides no generalizable dosing conclusions.

Citation

Titration of Bivalirudin Infusion in the Pediatric Cardiac Catheterization Laboratory: A Case Report.

Streiff A et al. · A&A practice, 2019

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

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.