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
This case series describes four patients with heparin-induced thrombocytopenia (HIT) who underwent HeartMate 3 left ventricular assist device implantation using a strategy of preoperative plasmapheresis, intraoperative unfractionated heparin, and postoperative conversion to bivalirudin. The study details the therapeutic challenges encountered and offers an alternative approach to decrease perioperative complications, though two of the four patients experienced postoperative bleeding complications on bivalirudin. The abstract does not mention leeches, hirudin, or leech therapy; bivalirudin is discussed solely as a pharmaceutical anticoagulant. Therefore, this study has no defensible relevance to ASH's domain of hirudotherapy or the leech secretome.
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: June 18, 2026