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    Anesth Analg. 2010 Sep;111(3):609-12. Epub 2010 Aug 4.

    Case report: a thrombus in the venous reservoir while using bivalirudin in a patient with heparin-induced thrombocytopenia undergoing heart transplantation.

    Wong JK, Tian Y, Shuttleworth P, Caffarelli AD, Reitz BA, Mora-Mangano CT.

    Source

    Division of Cardiovascular Anesthesia, and Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA. wongjk2003@yahoo.co

    Abstract

    Direct thrombin inhibitors are heparin alternatives for anticoagulation during cardiopulmonary bypass in patients with heparin-induced thrombocytopenia. We report a case of a large thrombus forming in the venous reservoir while using bivalirudin. We suggest that blood stasis associated with the full venous reservoir maintained in this case led to formation of a large thrombus at the top of the venous canister. Furthermore, activated clotting times may not accurately reflect the magnitude of anticoagulation when using direct thrombin inhibitors.

    PMID:
    20686010
    [PubMed - indexed for MEDLINE]
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