Bivalirudin for anticoagulation in cardiac surgery with cardiopulmonary bypass:a case series and literature review
Bian Luyu
Yan Shujie
Yu Kun
Guan Yulong
Teng Yuan
Liu Gang
Feng Chunlei
Wang Jing
Ji Bingyang
Abstract：Objective To evaluate the safety and feasibility of bivalirudin used for anticoagulation in cardiac surgery with cardiopulmonary bypass(CPB).Methods Through a retrospective analysis was conducted on clinical data from 5 patients who received bivalirudin anticoagulation during CPB at Fuwai Hospital,combined with a literature review to assess current strategies and unresolved challenges.Results Four patients received bivalirudin anticoagulation due to heparin-induced thrombocytopenia(HIT),while one patient was administered bivalirudin intraoperatively for heparin allergy.Activated clotting time(ACT)during CPB was maintained between 403 and 560 seconds.Postoperatively,ACT returned to<200 seconds within 2.5-19 hours.Chest closure time ranged from 1.5 to 7 hours,and 24-hour postoperative thoracic drainage volume was 290-840 ml.All patients recovered uneventfully without thrombotic events during or after surgery.Conclusion Bivalirudin demonstrates safety and feasibility as an anticoagulant for CPB in cardiac surgery.Despite potential bleeding risk,favorable patient outcomes suggest its viability as an alternative to heparin,particularly in HIT or heparin-allergic cases.
Keywords：BivalirudinCardiopulmonary bypassCardiac surgeryAnticoagulationHeparin-induced thrombocytopenia
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 204-209 )