Bivalirudin for Cardiopulmonary Bypass in the Setting of Heparin-Induced Thrombocytopenia and Combined Heart and Kidney Transplantation —Diagnostic and Therapeutic Challenges

SINCE THE PUBLICATION of the first case reports, heparin-induced thrombocytopenia (HIT) has persisted as a serious management dilemma for cardiothoracic anesthesiologists.1 –3 Nonimmune-mediated and immune-mediated forms of HIT, type I and II, respectively, both have been described in the literature.3–6 Of these 2 HIT phenotypes, the devastating and life-threatening thrombotic complications, such as limb ischemia, pulmonary embolism, stroke, and myocardial infarcti on, are almost associated exclusively with type-II HIT disease.

Source: Journal of Cardiothoracic and Vascular Anesthesia - October 12, 2016 Category: Anesthesiology Authors: Ankeet A. Choxi, Prakash A. Patel, John G. Augoustides, Julio Benitez-Lopez, Jacob T. Gutsche, Hani Murad, Yiliam F. Rodriguez-Blanco, Michael Fabbro, Kendall P. Crookston, Neal S. Gerstein Tags: Case ConferenceMark A. Chaney, MDSection Editors? > Source Type: research