Cerebrospinal Fluid Drainage With Bivalirudin and rFactor VIIa for Thoracic Aortic Aneurysm Surgery Using Left Atrial–Femoral Artery Bypass

Abstract

WHEN HEPARIN-INDUCED thrombocytopenia is diagnosed, direct thrombin inhibitors can be used in cases requiring cardiopulmonary bypass. Spinal drains are routinely used in preventing spinal cord ischemia for thoracoabdominal aneurysm repairs. Spinal drains placed before starting heparin anticoagulation are safe and routinely used. 1 Cheung A.T. Guvakov D.V. Weiss S.J. et al. Safety of lumbar drains in thoracic aortic operations performed with extracorporeal circulation. Ann Thorac Surg. 2003; 76: 1190-1196 Abstract Full Text Full Text PDF PubMed Scopus (75) Google Scholar The use of bivalirudin with a spinal drain for repair of a thoracoabdominal aneurysm in a patient with heparin-associated antibodies is reported. A good outcome was achieved by promoting coagulation with rFactor VIIa when ultrafiltration was not available to remove bivalirudin.