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SCVA March 2016 Podcast: Cardiopulmonary Bypass Without Heparin
SAGE Cardiology and Cardiovascular Medicine
English - April 12, 2016 23:49 - 22 minutes - 8.99 MBScience Health & Fitness Medicine medicine sage cardiology cardiovascular publications Homepage Download Apple Podcasts Google Podcasts Overcast Castro Pocket Casts RSS feed
Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin inhibitor such as bivalirudin. This review describes the use of heparin alternatives for the conduct of CPB with a focus on the direct thrombin inhibitors.
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