Recommendation Table 39.

Recommendations for alternative anticoagulation

Recommendations	Class a	Level b	Ref c
Bivalirudin should be considered as the first-line anticoagulation treatment in patients with acute HIT type 2 who require cardiac surgery.	IIa	B	503,504
Anticoagulation with argatroban may be considered in patients with acute HIT type 2 who require cardiac surgery with CPB and have significant renal dysfunction.	IIb	C	503,505

CPB: cardiopulmonary bypass; HIT: heparin-induced thrombocytopenia.

^aClass of recommendation.

^bLevel of evidence.

^cReferences.