Successful use of bivalirudin for combined carotid endarterectomy and coronary revascularization with the use of cardiopulmonary bypass in a patient with an elevated heparin-platelet factor 4 antibody titer.

Avery, Edwin G; Hilgenberg, Alan D; Cambria, Richard P; Beckerly, Rena; Donnelly, Anne M; Laposata, Michael · Anesth Analg · 2009

case_report · Level V

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Abstract

We report a combined carotid endarterectomy and coronary revascularization surgery with cardiopulmonary bypass using bivalirudin for systemic anticoagulation in a patient with a positive titer for the heparin-platelet factor 4 antibody. The patient experienced procedural success for both the carotid and coronary surgeries. Increased blood and blood product transfusion was required postoperatively.

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