Bidirectional Glenn shunt surgery using lepirudin anticoagulation in an infant with heparin-induced thrombocytopenia with thrombosis

Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, NY, USA.
Anesthesia & Analgesia (Impact Factor: 3.47). 08/2005; 101(1):74-6, table of contents. DOI: 10.1213/01.ANE.0000153019.15297.0B
Source: PubMed


There are few reports of the management of pediatric patients with heparin-induced thrombocytopenia (HIT) requiring cardiac surgery using currently available anticoagulants. We report a case of an infant with HIT requiring a bidirectional Glenn shunt who was successfully managed using lepirudin (r-hirudin, Refludan; Aventis, Bridgewater, NJ). Dosing and monitoring of anticoagulation were difficult, and we suggest caution in the use of lepirudin for cardiac surgery unless reliable monitoring of the degree of anticoagulation becomes available.

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