Successful pediatric heart transplantation with bivalirudin use in a cyanotic single ventricle patient with an intracorporeal continuous flow ventricular assist device and heparin-induced thrombocytopenia
Case report published in Indian Journal of Thoracic and Cardiovascular Surgery (2025)
Abstract
We describe a case of profound coagulopathy during orthotopic heart transplantation in a cyanotic single ventricle pediatric patient with an intracorporeal continuous flow ventricular assist device performed on bivalirudin for heparin-induced thrombocytopenia. This was successfully managed with central veno-arterial extracorporeal membrane oxygenation and hemofiltration as an adjunct to treat bivalirudin-induced coagulopathy due to lack of a reversal agent for bivalirudin.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Successful orthotopic heart transplant in a cyanotic single ventricle pediatric patient on continuous-flow VAD with HIT, with bivalirudin anticoagulation managed using V-A ECMO and hemofiltration as adjuncts due to lack of bivalirudin reversal agent.
Why This Matters for Hirudotherapy
This case report describes a cyanotic single-ventricle pediatric patient with an intracorporeal continuous-flow ventricular assist device and heparin-induced thrombocytopenia who underwent orthotopic heart transplantation anticoagulated with bivalirudin. Profound coagulopathy developed and was managed with central veno-arterial extracorporeal membrane oxygenation and hemofiltration, partly because bivalirudin lacks a reversal agent. The abstract does not mention hirudin, leeches, leech therapy, or the leech secretome. The evidence is limited to a single case report with minimal detail on outcomes beyond acute management. Bivalirudin (formerly Hirulog) is a synthetic peptide anticoagulant designed partly on the C-terminal sequence of hirudin, the anticoagulant of the medicinal leech (Maraganore et al., 1990); this paper studies the drug, not leech therapy.
Citation
Reference (Vancouver style)
Sainathan S, Mulinari L. Successful pediatric heart transplantation with bivalirudin use in a cyanotic single ventricle patient with an intracorporeal continuous flow ventricular assist device and heparin-induced thrombocytopenia. Indian J Thorac Cardiovasc Surg. 2025;41(7):933-936. doi:10.1007/s12055-024-01892-6. PMID: 40535220
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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