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CARDIOVASCULAR ANESTHESIA

Bivalirudin Monitored with the Ecarin Clotting Time for Anticoagulation During Cardiopulmonary Bypass

Andreas Koster, MD^*, Derek Chew, MD, Marcus Gründel, MD^*, Matthias Bauer, MD, Herman Kuppe, MD^*, and Bruce D. Spiess, MD

*Department of Anesthesia, Deutsches Herzzentrum Berlin, Berlin, Germany; Department of Cardiology, Flinders Medical Center, South Australia, Australia; Department for Thoracic and Cardiovascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany; and Department of Cardiothoracic Anesthesia, Virginia Commonwealth University, Richmond, Virginia

Address correspondence and reprint requests to Andreas Koster, MD, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany. Address e-mail to koster{at}dhzb.de

IMPLICATIONS:Bivalirudin, a new short-acting direct thrombin inhibitor, provides an elimination mechanism independent of specific organ function. We successfully used this new drug, monitored at the point of care via the ecarin clotting time, for anticoagulation during cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia heparin allergy and impaired renal function.

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