Related Experiment Videos
Argatroban use during pediatric interventional cardiac catheterization
Frank Cetta1, Lynn C Graham, Laura L Wrona
1Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois, USA. cetta.frank@mayo.edu
Summary
Argatroban, a direct thrombin inhibitor, was safely used for anticoagulation in a pediatric patient with heparin-induced thrombocytopenia during a transcatheter intervention. This demonstrates its potential as a heparin alternative in children.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Argatroban is an FDA-approved direct thrombin inhibitor for adults with heparin-induced thrombocytopenia (HIT).
- Its use in pediatric patients, particularly during interventional procedures, has not been previously reported.
- Heparin is commonly used for anticoagulation in pediatric cardiac interventions, but HIT poses a contraindication.
Observation:
- A pediatric patient with a history of HIT undergoing coil embolization of a Fontan fenestration received argatroban.
- A single bolus dose of 150 microg/kg argatroban was administered at the start of the procedure.
- Activated clotting time (ACT) was maintained above 200 seconds throughout the intervention.
Findings:
- The Fontan fenestration was successfully occluded using a detachable coil.
- The patient experienced no complications during or after the procedure.
- Activated clotting time returned to baseline within 72 minutes post-administration.
Implications:
- This case highlights the safe and effective use of argatroban in a pediatric patient with HIT undergoing a transcatheter intervention.
- Argatroban shows promise as a viable anticoagulation alternative to heparin in pediatric cardiology.
- Further research into argatroban's pediatric use is warranted to establish dosing and safety profiles.