Bivalirudin for Anticoagulation During Hypothermic Cardiopulmonary Bypass and Recombinant Factor VIIa for Iatrogenic Coagulopathy

Abstract

In the setting of DHCA, bivalirudin should be used cautiously, with frequent monitoring of the ACTs and potential cessation of the infusion in anticipation of prolonged drug effect with subsequent potential coagulopathy. If coagulopathy ensues, use of low-dose rFVIIa may be an option to initiate hemostasis. When using rFVIIa, it is important to consider the risk of thrombosis and monitor patients accordingly.