Bivalirudin for treatment of LVAD thrombosis: A case series

Lynne M. Sylvia*, Linda Ordway, Duc T. Pham, David DeNofrio, Michael Kiernan

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Both platelet- and fibrin-rich thrombi have been described in patients with pump thrombosis associated with continuous flow left ventricular assist devices (LVADs). Bivalirudin is a direct thrombin inhibitor that also inhibits platelet adhesion. Compared to heparin, this hirudin analog is less immunogenic, binds to both free- and clot-bound fibrin, and has a lower risk of major bleeding. In a recently published algorithm on the step-wise approach to the diagnosis and management of LVAD thrombosis, direct thrombin inhibitors were included as a treatment option in the setting of persistent hemolysis, power spikes, and heart failure symptoms. Evidence to support the use of a direct thrombin inhibitor for LVAD thrombosis is limited and anecdotal. We describe the first case series to date of the use of bivalirudin as an alternative to heparin in six hemodynamically stable patients with a total of ten hospitalizations for HeartMate II LVAD thrombosis. ASAIO Journal 2014; 60:744-747.

Original languageEnglish (US)
Pages (from-to)744-747
Number of pages4
JournalASAIO Journal
Volume60
Issue number6
DOIs
Publication statusPublished - Jan 1 2014

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Keywords

  • Bivalirudin
  • Direct thrombin inhibitor
  • LVAD
  • Thrombosis

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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