American Society of Hirudotherapy

A Review of Bivalirudin for Pediatric and Adult Mechanical Circulatory Support

Review published in American journal of cardiovascular drugs (2020)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentTaylor T et al. · American journal of cardiovascular drugs, 2020

Abstract

As the use of mechanical circulatory support has increased in volume and complexity, anticoagulation remains an intricate component of a patient's pharmacotherapy plan. Traditionally, heparin has been the primary anticoagulant utilized because of its ease of titration and  familiarity of use. More recently, bivalirudin, a direct thrombin inhibitor, has attracted attention as a potential alternative to traditional therapy. While labeled for use in percutaneous coronary interventions, it is utilized off-label for heparin-induced thrombocytopenia and mechanical circulatory support. A literature search identified ten studies in which bivalirudin was used in extracorporeal membrane oxygenation and five studies in which it was used in ventricular assist devices. The purpose of this review was to summarize the currently available literature for bivalirudin use for mechanical circulatory support in both adult and pediatric patients.

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

Publication typeJournal ArticleReview
Indexed MeSH termsAdultAntithrombinsChildDose-Response Relationship, DrugDrug Administration ScheduleExtracorporeal Membrane OxygenationHeart-Assist DevicesHirudinsHumansPeptide FragmentsRecombinant Proteins

Summary

A Review of Bivalirudin for Pediatric and Adult Mechanical Circulatory Support.

Why This Matters for Hirudotherapy

This review summarizes the available literature on bivalirudin for anticoagulation in adult and pediatric patients requiring mechanical circulatory support, including extracorporeal membrane oxygenation and ventricular assist devices. The abstract describes bivalirudin as a direct thrombin inhibitor with growing off-label use, particularly for heparin-induced thrombocytopenia and mechanical circulatory support, and identifies ten ECMO studies and five ventricular assist device studies. The abstract makes no mention of hirudin, leeches, or any connection to hirudotherapy, so no defensible ASH relevance can be drawn. As a literature review, it aggregates and summarizes existing publications without presenting new clinical or experimental findings.

Citation

A Review of Bivalirudin for Pediatric and Adult Mechanical Circulatory Support

Taylor T et al. · American journal of cardiovascular drugs, 2020

DOI

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

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