Abstract
The use of an alternative anticoagulant to heparin is required in patients undergoing on-pump cardiac surgery and who have been diagnosed with heparin hypersensitivity. Bivalirudin is an oligopeptide analogue of hirudin acting on thrombin through direct inhibition. It has a half-life of approximately 25 minutes, and is mostly cleared from the circulation by proteolytic enzymes. Its pharmacological properties make it an attractive alternative anticoagulant to heparin for patients presenting with heparin hypersensitivity requiring cardiac surgery. However, the normal surgical protocol needs adjusting to reect these properties. These changes mostly affect the perfusion setup and conduct on bypass
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