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Published in: Pediatric Cardiology 4/2008

01-07-2008 | Case Report

Successful Use of Bivalirudin for Superior Vena Cava Recanalization and Stent Placement in a Child with Heparin-Induced Thrombocytopenia

Authors: John P. Breinholt, Brady S. Moffett, Karen M. Texter, Frank F. Ing

Published in: Pediatric Cardiology | Issue 4/2008

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Abstract

Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening, adverse effect of heparin therapy. Patients with this complication require an alternative approach to anticoagulation. Bivalirudin is a direct thrombin inhibitor with an efficacy comparable to that of heparin, a short half-life, and reduced bleeding complications in adults. We present the case of a 2-year-old boy with HIT Type II who underwent recanalization of an occluded superior vena cava and stent placement, utilizing bivalirudin as anticoagulant.
Literature
1.
go back to reference Almond CS, Harrington J, Thiagarajan R et al (2006) Successful use of bivalirudin for cardiac transplantation in a child with heparin-induced thrombocytopenia. J Heart Lung Transplant 25:1376–1379PubMedCrossRef Almond CS, Harrington J, Thiagarajan R et al (2006) Successful use of bivalirudin for cardiac transplantation in a child with heparin-induced thrombocytopenia. J Heart Lung Transplant 25:1376–1379PubMedCrossRef
2.
go back to reference Arepally GM, Ortel TL (2006) Clinical practice. Heparin-induced thrombocytopenia. N Engl J Med 355:809–817CrossRef Arepally GM, Ortel TL (2006) Clinical practice. Heparin-induced thrombocytopenia. N Engl J Med 355:809–817CrossRef
3.
go back to reference Chew DP, Lincoff AM, Gurm H et al (2005) Bivalirudin versus heparin and glycoprotein IIb/IIIa inhibition among patients with renal impairment undergoing percutaneous coronary intervention (a subanalysis of the REPLACE-2 trial). Am J Cardiol 95:581–585PubMedCrossRef Chew DP, Lincoff AM, Gurm H et al (2005) Bivalirudin versus heparin and glycoprotein IIb/IIIa inhibition among patients with renal impairment undergoing percutaneous coronary intervention (a subanalysis of the REPLACE-2 trial). Am J Cardiol 95:581–585PubMedCrossRef
4.
go back to reference Freed MD, Keane JF, Rosenthal A (1974) The use of heparinization to prevent arterial thrombosis after percutaneous cardiac catheterization in children. Circulation 50:565–569PubMed Freed MD, Keane JF, Rosenthal A (1974) The use of heparinization to prevent arterial thrombosis after percutaneous cardiac catheterization in children. Circulation 50:565–569PubMed
5.
go back to reference Girolami B, Prandoni P, Stefani PM et al (2003) The incidence of heparin-induced thrombocytopenia in hospitalized medical patients treated with subcutaneous unfractionated heparin: a prospective cohort study. Blood 101:2955–2959PubMedCrossRef Girolami B, Prandoni P, Stefani PM et al (2003) The incidence of heparin-induced thrombocytopenia in hospitalized medical patients treated with subcutaneous unfractionated heparin: a prospective cohort study. Blood 101:2955–2959PubMedCrossRef
6.
go back to reference Huebler M, Koster A, Buz S et al (2006) Cardiopulmonary bypass for complex cardiac surgery using bivalirudin anticoagulation in a patient with heparin antibodies. J Card Surg 21:286–288PubMedCrossRef Huebler M, Koster A, Buz S et al (2006) Cardiopulmonary bypass for complex cardiac surgery using bivalirudin anticoagulation in a patient with heparin antibodies. J Card Surg 21:286–288PubMedCrossRef
7.
go back to reference Katzen BT, Ardid MI, MacLean AA et al (2005) Bivalirudin as an anticoagulation agent: safety and efficacy in peripheral interventions. J Vasc Interv Radiol 16:1183–1187, quiz 7PubMed Katzen BT, Ardid MI, MacLean AA et al (2005) Bivalirudin as an anticoagulation agent: safety and efficacy in peripheral interventions. J Vasc Interv Radiol 16:1183–1187, quiz 7PubMed
8.
go back to reference Koster A, Dyke CM, Aldea G et al (2007) Bivalirudin during cardiopulmonary bypass in patients with previous or acute heparin-induced thrombocytopenia and heparin antibodies: results of the CHOOSE-ON trial. Ann Thorac Surg 83:572–577PubMedCrossRef Koster A, Dyke CM, Aldea G et al (2007) Bivalirudin during cardiopulmonary bypass in patients with previous or acute heparin-induced thrombocytopenia and heparin antibodies: results of the CHOOSE-ON trial. Ann Thorac Surg 83:572–577PubMedCrossRef
9.
go back to reference Koster A, Spiess B, Chew DP et al (2004) Effectiveness of bivalirudin as a replacement for heparin during cardiopulmonary bypass in patients undergoing coronary artery bypass grafting. Am J Cardiol 93:356–359PubMedCrossRef Koster A, Spiess B, Chew DP et al (2004) Effectiveness of bivalirudin as a replacement for heparin during cardiopulmonary bypass in patients undergoing coronary artery bypass grafting. Am J Cardiol 93:356–359PubMedCrossRef
10.
go back to reference Koster A, Spiess B, Jurmann M et al (2006) Bivalirudin provides rapid, effective, and reliable anticoagulation during off-pump coronary revascularization: results of the “EVOLUTION OFF” trial. Anesth Analg 103:540–544PubMedCrossRef Koster A, Spiess B, Jurmann M et al (2006) Bivalirudin provides rapid, effective, and reliable anticoagulation during off-pump coronary revascularization: results of the “EVOLUTION OFF” trial. Anesth Analg 103:540–544PubMedCrossRef
11.
go back to reference Koster A, Weng Y, Bottcher W, Gromann T, Kuppe H, Hetzer R (2007) Successful use of bivalirudin as anticoagulant for ECMO in a patient with acute HIT. Ann Thorac Surg 83:1865–1967PubMedCrossRef Koster A, Weng Y, Bottcher W, Gromann T, Kuppe H, Hetzer R (2007) Successful use of bivalirudin as anticoagulant for ECMO in a patient with acute HIT. Ann Thorac Surg 83:1865–1967PubMedCrossRef
12.
go back to reference Lincoff AM, Bittl JA, Harrington RA et al (2003) Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention: REPLACE-2 randomized trial. JAMA 289:853–863PubMedCrossRef Lincoff AM, Bittl JA, Harrington RA et al (2003) Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention: REPLACE-2 randomized trial. JAMA 289:853–863PubMedCrossRef
13.
go back to reference Lincoff AM, Kleiman NS, Kereiakes DJ et al (2004) Long-term efficacy of bivalirudin and provisional glycoprotein IIb/IIIa blockade vs heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary revascularization: REPLACE-2 randomized trial. JAMA 292:696–703PubMedCrossRef Lincoff AM, Kleiman NS, Kereiakes DJ et al (2004) Long-term efficacy of bivalirudin and provisional glycoprotein IIb/IIIa blockade vs heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary revascularization: REPLACE-2 randomized trial. JAMA 292:696–703PubMedCrossRef
14.
go back to reference Murphy GS, Marymont JH (2007) Alternative anticoagulation management strategies for the patient with heparin-induced thrombocytopenia undergoing cardiac surgery. J Cardiothorac Vasc Anesth 21:113–126PubMedCrossRef Murphy GS, Marymont JH (2007) Alternative anticoagulation management strategies for the patient with heparin-induced thrombocytopenia undergoing cardiac surgery. J Cardiothorac Vasc Anesth 21:113–126PubMedCrossRef
15.
go back to reference Pappalardo F, Franco A, Crescenzi G, Poli A, Zangrillo A, Koster A (2007) Successful use of bivalirudin for cardiopulmonary bypass in a patient with heparin allergy. Perfusion 22:67–69PubMedCrossRef Pappalardo F, Franco A, Crescenzi G, Poli A, Zangrillo A, Koster A (2007) Successful use of bivalirudin for cardiopulmonary bypass in a patient with heparin allergy. Perfusion 22:67–69PubMedCrossRef
16.
go back to reference Ranze O, Ranze P, Magnani HN, Greinacher A (1999) Heparin-induced thrombocytopenia in paediatric patients–a review of the literature and a new case treated with danaparoid sodium. Eur J Pediatr 158(Suppl 3):S130–S133PubMedCrossRef Ranze O, Ranze P, Magnani HN, Greinacher A (1999) Heparin-induced thrombocytopenia in paediatric patients–a review of the literature and a new case treated with danaparoid sodium. Eur J Pediatr 158(Suppl 3):S130–S133PubMedCrossRef
17.
go back to reference Risch L, Huber AR, Schmugge M (2006) Diagnosis and treatment of heparin-induced thrombocytopenia in neonates and children. Thromb Res 118:123–135PubMedCrossRef Risch L, Huber AR, Schmugge M (2006) Diagnosis and treatment of heparin-induced thrombocytopenia in neonates and children. Thromb Res 118:123–135PubMedCrossRef
18.
go back to reference Seybert AL, Coons JC, Zerumsky K (2006) Treatment of heparin-induced thrombocytopenia: is there a role for bivalirudin? Pharmacotherapy 26:229–241PubMedCrossRef Seybert AL, Coons JC, Zerumsky K (2006) Treatment of heparin-induced thrombocytopenia: is there a role for bivalirudin? Pharmacotherapy 26:229–241PubMedCrossRef
19.
go back to reference Shammas NW, Allie D, Hall P et al (2005) Predictors of in-hospital and 30-day complications of peripheral vascular interventions using bivalirudin as the primary anticoagulant: results from the APPROVE Registry. J Invasive Cardiol 17:356–359PubMed Shammas NW, Allie D, Hall P et al (2005) Predictors of in-hospital and 30-day complications of peripheral vascular interventions using bivalirudin as the primary anticoagulant: results from the APPROVE Registry. J Invasive Cardiol 17:356–359PubMed
20.
go back to reference Shammas NW, Lemke JH, Dippel EJ et al (2003) Bivalirudin in peripheral vascular interventions: a single center experience. J Invasive Cardiol 15:401–404PubMed Shammas NW, Lemke JH, Dippel EJ et al (2003) Bivalirudin in peripheral vascular interventions: a single center experience. J Invasive Cardiol 15:401–404PubMed
21.
go back to reference Stone GW, White HD, Ohman EM et al (2007) Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial. Lancet 369:907–919PubMedCrossRef Stone GW, White HD, Ohman EM et al (2007) Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial. Lancet 369:907–919PubMedCrossRef
22.
go back to reference Weitz JI, Bates SM (2002) Acute coronary syndromes: a focus on thrombin. J Invasive Cardiol 14(Suppl B):2B–7BPubMed Weitz JI, Bates SM (2002) Acute coronary syndromes: a focus on thrombin. J Invasive Cardiol 14(Suppl B):2B–7BPubMed
23.
go back to reference Young G, Tarantino MD, Wohrley J, Weber LC, Belvedere M, Nugent DJ (2007) Pilot dose-finding and safety study of bivalirudin in infants <6 months of age with thrombosis. J Thromb Haemost 5:1654–1659PubMedCrossRef Young G, Tarantino MD, Wohrley J, Weber LC, Belvedere M, Nugent DJ (2007) Pilot dose-finding and safety study of bivalirudin in infants <6 months of age with thrombosis. J Thromb Haemost 5:1654–1659PubMedCrossRef
Metadata
Title
Successful Use of Bivalirudin for Superior Vena Cava Recanalization and Stent Placement in a Child with Heparin-Induced Thrombocytopenia
Authors
John P. Breinholt
Brady S. Moffett
Karen M. Texter
Frank F. Ing
Publication date
01-07-2008
Publisher
Springer-Verlag
Published in
Pediatric Cardiology / Issue 4/2008
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-008-9231-2

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