American Society of Hirudotherapy

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

Research article published in Journal of cardiothoracic and vascular anesthesia (2021)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportDrug DevelopmentColbaugh Z et al. · 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.

Publication typeCase ReportsResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tJournal Article
Indexed MeSH termsAnticoagulantsCardiac CatheterizationHeart Valve Prosthesis ImplantationHirudinsHumansMitral Valve InsufficiencyPeptide FragmentsRecombinant ProteinsThrombocytopeniaTreatment OutcomeTricuspid Valve

Summary

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.

Why This Matters for Hirudotherapy

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. Therefore, this article has no defensible relevance to ASH's domain.

Citation

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

Colbaugh Z et al. · Journal of cardiothoracic and vascular anesthesia, 2021

DOI

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

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