20.500.12556/DiRROS-29137 Left ventricular assist device implantation under argatroban anticoagulation in heparin-induced thrombocytopenia a literature review and clinical case presentation This review provides an in-depth analysis of argatroban as an alternative anticoagulant in cardiac surgery, with a focus on its use in patients with heparin-induced thrombocytopenia (HIT). We examine argatroban's pharmacokinetics and dosing regimens and the challenges associated with cosnventional monitoring methods-such as activated clotting time (ACT) and activated partial thromboplastin time (aPTT)-to evaluate its safety and effectiveness in high-risk surgical settings. Drawing on data from multiple case reports and series, our review highlights both the potential benefits and limitations of argatroban, including complications such as clot formation in extracorporeal circulation systems and prolonged postoperative coagulopathy. In addition to the literature review, we present a detailed clinical case of urgent HeartMate 3 left ventricular assist device implantation in a patient with advanced heart failure and active HIT. In this case, despite targeting an ACT above 400 s, intraoperative complications such as clot formation in the heart-lung machine and difficulty achieving hemostasis highlight the need for improved monitoring and dosing protocols. Our findings call for refined anticoagulation strategies and advanced monitoring techniques to optimize argatroban use in cardiac surgery, offering valuable insights for clinicians managing complex scenarios where conventional heparin therapy is contraindicated. heart failure left ventricular assist device heparin-induced thrombocytopenia argatroban anticoagulation heart transplantation cardiac surgery srčno popuščanje naprava za pomoč levemu prekatu s heparinom povzročena trombocitopenija argatroban antikoagulacija presaditev srca operacija srca true false true Angleški jezik Slovenski jezik Neznano 2026-04-22 09:36:03 2026-04-22 09:36:03 2026-04-23 04:02:11 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 2. 7. 2025; str. 1-10 iss. 12, [article no.] 4083 Vol. 14 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 2077-0383 10.3390/jcm14124083 241039363 RAZ_Ksela_Jus_2025.pdf RAZ_Ksela_Jus_2025.pdf 1 A4A090FCB6D5C9C7A571C3CA420CDEA9 3cd8c36307acdd888ae5595657481e4c2e3ecf7622fbe57560860cdf70aadf33 057ac641-3e1e-11f1-a343-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43537 https://www.mdpi.com/2077-0383/14/12/4083 1 ec5b4d74-3e1d-11f1-a343-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43536 Univerzitetni klinični center Ljubljana 0 0 0