Coagulopatía fulminante tras el uso de bivalirudina en un paciente diagnosticado de trombocitopenia inducida por heparina y sometido a cirugía cardiaca con circulación extracorpórea

We present the case of a patient diagnosed with heparin-induced thrombocytopenia and heparin-PF4 (+) antibodies requiring a triple cardiac valve replacement who developed fulminant coagulopathy after bivalirudin administration. A discussion on the serious difficulties that the management of these types of patients involves, as well as a review of prevention strategies are presented.