Bivalirudin vs. Unfractionated Heparin in Orthotopic Heart Transplant Patients Undergoing Outpatient IVUS Procedures

Atwal, Danish

Bivalirudin vs. Unfractionated Heparin in Orthotopic Heart Transplant Patients Undergoing Outpatient IVUS Procedures

Wednesday, May 22, 2019

Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)

Danish Atwal, M.D. , Division of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ

Stephen Sabyan, RT CV , Mayo Clinic Arizona, Phoenix, AZ

Richard W Lee, MD , Mayo Clinic Arizona, Phoenix, AZ

Eric H. Yang, M.D. , Mayo Clinic Arizona, Phoenix, AZ

John P Sweeney, MD , Mayo Clinic Arizona, Phoenix, AZ

F. David D. Fortuin, M.D. , Mayo Clinic Arizona, Phoenix, AZ

Background
Anticoagulation strategies for intravascular ultrasound (IVUS) in orthotopic heart transplant (OHT) patients are bivalirudin or unfractionated heparin (UFH), however these strategies have not been compared to each other.

Methods
We performed a retrospective analysis of outpatient OHT patients who underwent IVUS via femoral access at our institution from 1/1/2013 to 8/1/2018. Variables including time to sheath pull and time to discharge were compared. We also looked at safety endpoints such as bleeding and access site complications. T-test was used to compare groups.

Results
We found 121 OHT patients who met the study criteria. Times from procedure end to sheath pull and from procedure start to discharge in bivalirudin group vs. UFH group were not different (fig 1 and 2). Four patients had hematoma in the UFH group and none in the bivalirudin group.

Conclusions
There is no difference in time from procedure end to sheath removal and from procedure start to patient discharge following IVUS using bivalirudin vs UFH. There is no difference in bleeding or access site complications.