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Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY USA
Address correspondence to Ellen D. Iannoli, M.D., 601 Elmwood Avenue Box 604, Rochester, NY 14642. Address e-mail to Ellen_iannoli{at}urmc.rochester.edu.
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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