scholarly journals Novel use of plasmapheresis in a patient with heparin-induced thrombocytopenia requiring urgent insertion of a left ventricular assist device under cardiopulmonary bypass

2010 ◽  
Vol 140 (3) ◽  
pp. e56-e58 ◽  
Author(s):  
Rochus K. Voeller ◽  
Spencer J. Melby ◽  
Brett E. Grizzell ◽  
Nader Moazami
Keyword(s):  
Cardiopulmonary Bypass ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Heparin Induced Thrombocytopenia ◽  
Left Ventricular Assist

Use of Systemic Bivalirudin and an Anticoagulant-Free Purge Solution in a Percutaneous Left Ventricular Assist Device in a Patient With Heparin-Induced Thrombocytopenia

2020 ◽  
pp. 089719002093053 ◽  
Author(s):  
Hasan Kazmi ◽  
Ashley E. Milkovits
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Heparin Induced Thrombocytopenia ◽  
Cardiac Catheterization Laboratory ◽  
Left Ventricular Assist ◽  
History Of

The use of systemic bivalirudin and an anticoagulant-free purge solution in a percutaneous left ventricular assist device (pVAD) is described in a patient with a history of heparin-induced thrombocytopenia (HIT). An 80-year-old man with a past medical history of severe aortic stenosis and HIT was transferred to our facility for cardiogenic shock. The patient was emergently taken to the cardiac catheterization laboratory for balloon valvuloplasty and Impella pVAD (Abiomed, Inc) implantation. Due to the history of HIT, bivalirudin was chosen as an alternative anticoagulant. The device representative suggested adding bivalirudin 20 mg/500 mL to the Impella purge solution. However, due to the negligible amount of bivalirudin this would provide in comparison to patient’s systemic intravenous bivalirudin dose, we elected not to add bivalirudin to the purge solution. The patient remained on the Impella for 72 hours with intravenous bivalirudin without any evidence of pump thrombosis as evidenced by unchanging flows and stable purge pressures. Unfortunately, despite functional Impella pVAD support, care was withdrawn due to ongoing multi-organ failure. This patient case demonstrated the safe, effective, and practical use of an anticoagulant-free purge solution with systemic bivalirudin in a patient with 72 hours of Impella support.

Heparin-Induced Thrombocytopenia in Left Ventricular Assist Device Bridge-to-Transplant Patients

2007 ◽  
Vol 84 (3) ◽  
pp. 841-846 ◽  
Author(s):  
Jacob N. Schroder ◽  
Mani A. Daneshmand ◽  
Nestor R. Villamizar ◽  
Rebecca P. Petersen ◽  
Laura J. Blue ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Heparin Induced Thrombocytopenia ◽  
Bridge To Transplant ◽  
Transplant Patients ◽  
Left Ventricular Assist
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