Successful anticoagulation with bivalirudin in antithrombin-deficient pediatric patient undergoing stent placement.

Many pediatric patients requiring anticoagulation during interventional heart catheterizations have antithrombin (AT) deficiency. AT is a necessary cofactor for heparin inhibition of thrombin. Without sufficient AT, these patients are at increased risk for thrombotic complications. This case describes the successful use of bivalirudin, a direct thrombin inhibitor, as an anticoagulant in a 2-month old infant with AT deficiency undergoing stent placement.