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Bivalirudin and transcatheter aortic valve replacement: a cautionary tale
Niravkumar K Sangani1, Kevin L Greason1, Norman E Torres2
1Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Abstract:
Bivalirudin is an accepted alternative to heparin for anticoagulation during select cardiac procedures. Its use has not been well described during transcatheter aortic valve replacement. Herein is the report of a transcatheter valve replacement case that was complicated by catastrophe and need for emergent cardiopulmonary bypass. A successful outcome was achieved. However, the inability to rapidly reverse the anticoagulation effect of bivalirudin proved troublesome, and that provides for a cautionary tale about its use during transcatheter valve replacement.
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