Bivalirudin as a Systemic Anticoagulant and Flush Solution Additive for Sequential Mitral and Tricuspid Valve Percutaneous Edge-to-Edge Repair in a Patient With Heparin-Induced Thrombocytopenia
Case report published in Journal of cardiothoracic and vascular anesthesia (2021)
Abstract
Herein the case of a patient with a prior history of heparin-induced thrombocytopenia who underwent percutaneous mitral valve edge-to-edge repair that was followed by a tricuspid edge-to-edge repair two months later is presented. Recommendations exist for systemic anticoagulant alternatives for percutaneous mitral valve edge-to-edge repair with the MitraClip device (Abbott, Chicago, IL), but minimal guidance and experience are present regarding alternative systemic anticoagulation during the performance of right-sided interventions, including tricuspid edge-to-edge repair (TriClip; Abbott). Notably, there is no clear consensus regarding the use of an alternative anticoagulant in the catheter flush solution for the delivery systems used during these procedures, particularly for right-sided interventions.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
This case report describes the use of bivalirudin as systemic anticoagulant and flush solution additive for sequential mitral and tricuspid edge-to-edge repairs in a patient with prior heparin-induced thrombocytopenia, where guidance on right-sided procedures remains limited.
Context
This case report describes a patient with a prior history of heparin-induced thrombocytopenia who underwent a percutaneous mitral valve edge-to-edge repair followed by a tricuspid edge-to-edge repair two months later. The authors highlight the lack of established guidance and clinical experience regarding alternative systemic anticoagulation, as well as the lack of consensus on alternative anticoagulants in catheter flush solutions, particularly for right-sided interventions. The abstract does not specify which alternative anticoagulants were used or mention any connection to leeches, hirudin, or leech therapy.
Citation
Reference (Vancouver style)
Colbaugh Z, Watts TE 3rd, Ahmed MI, Addis DR. Bivalirudin as a Systemic Anticoagulant and Flush Solution Additive for Sequential Mitral and Tricuspid Valve Percutaneous Edge-to-Edge Repair in a Patient With Heparin-Induced Thrombocytopenia. J Cardiothorac Vasc Anesth. 2022;36(6):1709-1714. doi:10.1053/j.jvca.2021.03.004. PMID: 33836962
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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