As the use of mechanical circulatory support has increased in volume and complexity, anticoagulation remains an intricate component of a patient’s pharmacotherapy plan. Traditionally, heparin has been the primary anticoagulant utilized because of its ease of titration and familiarity of use. More recently, bivalirudin, a direct thrombin inhibitor, has attracted attention as a potential alternative to traditional therapy. While labeled for use in percutaneous coronary interventions, it is utilized off-label for heparin-induced thrombocytopenia and mechanical circulatory support. A literature search identified ten studies in which bivalirudin was used in extracorporeal membrane oxygenation and five studies in which it was used in ventricular assist devices. The purpose of this review was to summarize the currently available literature for bivalirudin use for mechanical circulatory support in both adult and pediatric patients.

随着机械循环支持的使用量和复杂性的增加，抗凝治疗仍然是患者药物治疗计划的一个复杂组成部分。传统上，肝素一直是使用的主要抗凝剂，因为它易于滴定和使用熟悉。最近，直接凝血酶抑制剂比伐卢定作为传统疗法的潜在替代品引起了人们的注意。虽然标记为用于经皮冠状动脉介入治疗，但它被用于肝素诱导的血小板减少症和机械循环支持的标签外。一项文献检索确定了十项将比伐卢定用于体外膜肺氧合的研究和五项将其用于心室辅助装置的研究。