Bivalirudin for cardiac catheterization in a pediatric patient with religious objection to the use of porcine-derived heparin

Abstract

Various clinical scenarios may require the short or long- term administration of agents to provide anticoagulation. In the vast majority of scenarios and clinical situa- tions, heparin remains the agent of choice. However, patient concerns or conditions such as heparin-induced thrombocytopenia (HIT) or religious concerns regarding the use of porcine-derived medications may require the use of alternative anticoagulants. We present the use of bivalirudin for anticoagulation during a cardiac catheterization procedure in a 9-year-old patient of the Islamic faith who requested no porcine-derived medications. Basic principles of bivalirudin are discussed, previous reports of its use during cardiac catheterization re- viewed, and clinical guidelines for its use in this clinical scenario presented.

Keywords

• anticoagulation
• heparin
• bivalirudin