Management of Heparin-Induced Thrombocytopenia Using Plasmapharesis in Patients Undergoing HeartMate 3 Left Ventricular Assist Device
Research article published in ASAIO journal (2021)
Abstract
Heparin-induced thrombocytopenia (HIT) type-2 is a rare, but life-threatening complication that presents a unique challenge in patients undergoing cardiac surgery. Patients that require cardiac surgery with HIT present a dilemma between intraoperative anticoagulation, perioperative bleeding risk, and perioperative thrombotic events. We describe a case series of four patients who developed HIT in their hospital course before HeartMate 3 (HM3) left ventricular assist device implantation. Following a multidisciplinary approach, all patients did well intraoperatively with an approach of preoperative plasmapheresis, intraoperative unfractionated heparin (UFH), and postoperative conversion to bivalirudin with a bridge to warfarin. However, two patients had postoperative bleeding complications on bivalirudin. This case series details the therapeutic challenges encountered for HM3 implantation in patients with HIT and offers a therapeutic alternative to intraoperative bivalirudin in the effort to decrease perioperative complications in this challenging patient population.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Management of Heparin-Induced Thrombocytopenia Using Plasmapharesis in Patients Undergoing HeartMate 3 Left Ventricular Assist Device.
Por qué esto importa para la hirudoterapia
Esta serie de casos describe a cuatro pacientes con trombocitopenia inducida por heparina (TIH) que fueron sometidos a implante de dispositivo de asistencia ventricular izquierda HeartMate 3 utilizando una estrategia de plasmaféresis preoperatoria, heparina no fraccionada intraoperatoria y conversión postoperatoria a bivalirudina. El estudio detalla los desafíos terapéuticos encontrados y ofrece un enfoque alternativo para disminuir las complicaciones perioperatorias, aunque dos de los cuatro pacientes presentaron complicaciones hemorrágicas postoperatorias con bivalirudina. El resumen no menciona sanguijuelas, hirudina ni terapia con sanguijuelas; la bivalirudina se analiza únicamente como anticoagulante farmacéutico. Por lo tanto, este estudio no tiene una relevancia defendible para el ámbito de la hirudoterapia o el secretoma de la sanguijuela de la ASH.
Citación
Management of Heparin-Induced Thrombocytopenia Using Plasmapharesis in Patients Undergoing HeartMate 3 Left Ventricular Assist Device
Naqvi SY et al. · ASAIO journal, 2021
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026