{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:07:02Z","timestamp":1785575222736,"version":"3.56.0"},"reference-count":5,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>The use of systemic bivalirudin and an anticoagulant-free purge solution in a percutaneous left ventricular assist device (pVAD) is described in a patient with a history of heparin-induced thrombocytopenia (HIT). An 80-year-old man with a past medical history of severe aortic stenosis and HIT was transferred to our facility for cardiogenic shock. The patient was emergently taken to the cardiac catheterization laboratory for balloon valvuloplasty and Impella pVAD (Abiomed, Inc) implantation. Due to the history of HIT, bivalirudin was chosen as an alternative anticoagulant. The device representative suggested adding bivalirudin 20 mg\/500 mL to the Impella purge solution. However, due to the negligible amount of bivalirudin this would provide in comparison to patient\u2019s systemic intravenous bivalirudin dose, we elected not to add bivalirudin to the purge solution. The patient remained on the Impella for 72 hours with intravenous bivalirudin without any evidence of pump thrombosis as evidenced by unchanging flows and stable purge pressures. Unfortunately, despite functional Impella pVAD support, care was withdrawn due to ongoing multi-organ failure. This patient case demonstrated the safe, effective, and practical use of an anticoagulant-free purge solution with systemic bivalirudin in a patient with 72 hours of Impella support.<\/jats:p>","DOI":"10.1177\/0897190020930530","type":"journal-article","created":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T06:35:03Z","timestamp":1591598103000},"page":"662-664","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Use of Systemic Bivalirudin and an Anticoagulant-Free Purge Solution in a Percutaneous Left Ventricular Assist Device in a Patient With Heparin-Induced Thrombocytopenia"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0049-1228","authenticated-orcid":false,"given":"Hasan","family":"Kazmi","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services, Carilion Roanoke Memorial Hospital, Roanoke, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley E.","family":"Milkovits","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Carilion Roanoke Memorial Hospital, Roanoke, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,6,8]]},"reference":[{"key":"bibr1-0897190020930530","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1995"},{"key":"bibr2-0897190020930530","volume-title":"Impella Ventricular Support Systems for Use During Cardiogenic Shock. Impella 2.5, 5.0, LD and Impella CP Instructions for Use and Clinical Reference Manual","author":"Abiomed Inc","year":"2016"},{"key":"bibr3-0897190020930530","doi-asserted-by":"publisher","DOI":"10.1177\/0897190017727191"},{"key":"bibr4-0897190020930530","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp160212"},{"key":"bibr5-0897190020930530","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp100016"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190020930530","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0897190020930530","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190020930530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:36:00Z","timestamp":1777509360000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0897190020930530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,8]]},"references-count":5,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1177\/0897190020930530"],"URL":"https:\/\/doi.org\/10.1177\/0897190020930530","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,8]]}}}