PMID- 36943709
OWN - NLM
STAT- MEDLINE
DCOM- 20230503
LR  - 20231104
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 69
IP  - 5
DP  - 2023 May 1
TI  - Bivalirudin Compared to Heparin as the Primary Anticoagulant in Pediatric Berlin 
      Heart Recipients.
PG  - e205-e211
LID - 10.1097/MAT.0000000000001921 [doi]
AB  - Bivalirudin has been used in increasing frequency as an alternative to 
      unfractionated heparin (UFH) in pediatric recipients of Berlin Heart EXCOR 
      ventricular assist devices (VAD). This single-center, retrospective review 
      characterizes anticoagulant trends and outcomes in pediatric Berlin Heart VAD 
      recipients implanted between September 1, 2013, and August 31, 2021, 
      anticoagulated with either bivalirudin or UFH. Thirty-one patients were included; 
      65% who received bivalirudin and 35% who received UFH. The median age was 2.9 
      years, included 64.5% females, with 61.3% of patients diagnosed with dilated 
      cardiomyopathy and 25.8% of patients with congenital heart disease. Therapeutic 
      anticoagulation was achieved sooner in the bivalirudin group compared to UFH via 
      anti-Xa monitoring (median 5.7 and 69.5 hours, respectively, p < 0.001). 
      Bivalirudin had a greater number of therapeutic values comparatively to UFH (52% 
      and 24%, respectively; p < 0.001) and a superior number of hours in the 
      therapeutic range (67% and 32%, respectively; p < 0.001). Secondary outcomes were 
      similar among the two groups, apart from greater chest tube output (UFH), more 
      frequent events of elevated plasma-free hemoglobin (bivalirudin), and more 
      frequent elevated inflammatory markers postimplant (bivalirudin). Prevalence of 
      pump replacements secondary to significant clot burden and prevalence of stroke 
      was comparable. In this patient cohort, bivalirudin demonstrated greater 
      anticoagulation stability comparatively to UFH. Multicenter collaboration would 
      be necessary to identify whether this further translates into improved patient 
      outcomes.
CI  - Copyright (c) ASAIO 2023.
FAU - Freniere, Victoria
AU  - Freniere V
AUID- ORCID: 0000-0001-5385-8279
AD  - From the Department of Pharmacy, NewYork-Presbyterian Hospital.
FAU - Salerno, David M
AU  - Salerno DM
AUID- ORCID: 0000-0002-5450-3995
AD  - From the Department of Pharmacy, NewYork-Presbyterian Hospital.
FAU - Corbo, Heather
AU  - Corbo H
AUID- ORCID: 0000-0002-2521-2080
AD  - From the Department of Pharmacy, NewYork-Presbyterian Hospital.
FAU - Law, Sabrina
AU  - Law S
AD  - Department of Pediatrics, Columbia University Irving Medical Center, New York, 
      New York.
FAU - McAllister, Jennie
AU  - McAllister J
AD  - Department of Pediatrics, Columbia University Irving Medical Center, New York, 
      New York.
FAU - Neunert, Cindy
AU  - Neunert C
AUID- ORCID: 0000-0001-6753-6107
AD  - Department of Pediatrics, Columbia University Irving Medical Center, New York, 
      New York.
FAU - Chen, Justin K
AU  - Chen JK
AUID- ORCID: 0000-0003-1215-7390
AD  - From the Department of Pharmacy, NewYork-Presbyterian Hospital.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230320
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - 9005-49-6 (Heparin)
RN  - 0 (Anticoagulants)
RN  - TN9BEX005G (bivalirudin)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 0 (Antithrombins)
SB  - IM
CIN - ASAIO J. 2023 Nov 1;69(11):e468-e469. PMID: 37220194
CIN - ASAIO J. 2023 Nov 1;69(11):e467. PMID: 37220195
MH  - Female
MH  - Humans
MH  - Child
MH  - Child, Preschool
MH  - Male
MH  - *Heparin/therapeutic use
MH  - *Anticoagulants/therapeutic use
MH  - Treatment Outcome
MH  - Hirudins
MH  - Peptide Fragments/therapeutic use
MH  - Retrospective Studies
MH  - Recombinant Proteins
MH  - Antithrombins/therapeutic use
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2023/03/22 06:00
MHDA- 2023/05/03 06:42
CRDT- 2023/03/21 12:33
PHST- 2023/05/03 06:42 [medline]
PHST- 2023/03/22 06:00 [pubmed]
PHST- 2023/03/21 12:33 [entrez]
AID - 00002480-202305000-00020 [pii]
AID - 10.1097/MAT.0000000000001921 [doi]
PST - ppublish
SO  - ASAIO J. 2023 May 1;69(5):e205-e211. doi: 10.1097/MAT.0000000000001921. Epub 2023 
      Mar 20.