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Double valve replacement in a patient with anticardiolipin antibody syndrome
1Department of Cardiovascular Surgery, QEII Health Sciences Center, Halifax, Nova Scotia, Canada. edit@ns.sympatico.ca
Insights
Cardiopulmonary bypass (CPB) is safe for patients with anticardiolipin antibody syndrome during valve replacement surgery. Careful monitoring ensures an uneventful recovery, highlighting the feasibility of CPB in complex hypercoagulable conditions.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Immunology
Background:
- Anticardiolipin (antiphospholipid) antibody syndrome is a rare hypercoagulable condition.
- Cardiopulmonary bypass (CPB) is a critical procedure for cardiac surgeries, including valve replacement.
- The presence of antiphospholipid antibodies poses potential risks during CPB due to hypercoagulability.
Observation:
- A 43-year-old female patient with anticardiolipin antibody syndrome underwent aortic and mitral valve replacement.
- The patient required cardiopulmonary bypass for the cardiac procedure.
- The clinical course during CPB and post-operatively was uneventful.
Findings:
- Cardiopulmonary bypass can be performed safely in patients with anticardiolipin antibody syndrome.
- Diligent hematological monitoring is crucial for managing patients with this condition during CPB.
- This case adds to the limited reported instances of CPB in patients with antiphospholipid antibodies, particularly in valve replacement.
Implications:
- CPB is a viable option for selected patients with antiphospholipid antibody syndrome requiring valve surgery.
- Effective management strategies can mitigate risks associated with hypercoagulability during CPB.
- Further research and case reports are needed to refine protocols for CPB in patients with autoimmune hypercoagulable states.
Abstract:
Cardiopulmonary bypass (CPB) was used during the replacement of the aortic and mitral valves in a 43-year-old female patient. The case was complicated by the presence of a rare hypercoagulable condition called anticardiolipin (antiphospholipid) antibody syndrome. The course of bypass was uneventful and the patient was released from the intensive care unit on the first postoperative day. CPB in the presence of anticardiolipin antibodies is an unusual situation that requires diligent hematological monitoring. Since 1989 there have been only 14 reported cases of these antibodies and cardiopulmonary bypass. Eight of these have involved valve replacements.