Cerebrospinal fluid drainage with bivalirudin and rFactor VIIa for thoracic aortic aneurysm surgery using left atrial-femoral artery bypass.

摘要

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 The use of biva-lirudin 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 Vila when ultrafiltration was not available to remove bivalirudin.