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Background <p>Heparin-induced thrombocytopenia rules out the possibility of adopting heparin for cardiopulmonary bypass. To overcome this problem two anticoagulants can be used: argatroban and bivalirudin.</p> Case presentation <p>We report on the adoption of argatroban during cardiopulmonary bypass for heart transplantation in a patient affected by HIT, previously implanted with a left ventricular assist device. Despite appropriate dosing, anticoagulation reversal proved ineffective, resulting in uncontrollable coagulopathy and fatal haemorrhage.</p> Conclusions <p>Argatroban could be an effective option for selected patients but more studies and particular attention are required, especially in patients with previous left ventricular assist device implantation.</p>

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Use of argatroban as anticoagulation for cardiopulmonary bypass during heart transplantation: A case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月18日

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  • Marika Faggioli,
  • Daniela Bacich,
  • Chiara Tessari,
  • Fabio Zanella,
  • Demetrio Pittarello,
  • Annalisa Angelini,
  • Augusto D’Onofrio,
  • Vincenzo Tarzia,
  • Gerosa Gino

摘要

Background

Heparin-induced thrombocytopenia rules out the possibility of adopting heparin for cardiopulmonary bypass. To overcome this problem two anticoagulants can be used: argatroban and bivalirudin.

Case presentation

We report on the adoption of argatroban during cardiopulmonary bypass for heart transplantation in a patient affected by HIT, previously implanted with a left ventricular assist device. Despite appropriate dosing, anticoagulation reversal proved ineffective, resulting in uncontrollable coagulopathy and fatal haemorrhage.

Conclusions

Argatroban could be an effective option for selected patients but more studies and particular attention are required, especially in patients with previous left ventricular assist device implantation.