Use of argatroban as anticoagulation for cardiopulmonary bypass during heart transplantation: A case report
Abstract
Background: Heparin-induced thrombocytopenia rules out the possibility of adopting heparin for cardiopulmonary bypass. To overcome this problem two anticoagulants can be used: argatroban and bivalirudin.
Case presentation: We report on the adoption of argatroban during cardiopulmonary bypass for heart transplantation in a patient affected by HIT, previously implanted with a left ventricular assist device. Despite appropriate dosing, anticoagulation reversal proved ineffective, resulting in uncontrollable coagulopathy and fatal haemorrhage.
Conclusions: Argatroban could be an effective option for selected patients but more studies and particular attention are required, especially in patients with previous left ventricular assist device implantation.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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