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

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.

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A case report presents a 4-year-old with complex congenital heart disease and a prior episode of heparin-induced thrombocytopenia who needed an increased bivalirudin dose during cardiac catheterization, illustrating how pediatric bivalirudin dosing is still largely extrapolated from adult data.

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