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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Aortic valve replacement in a patient with the prothrombin 20210A mutation
Samuel M Galvagno1, Teresa M Bean, Michael McAdams
1Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiac Surgery, Brigham and Woman's Hospital, Boston, Massachusetts 02115, USA.
The Annals of Thoracic Surgery
|September 25, 2007
Summary
Managing patients with hypercoagulable states undergoing cardiac surgery is challenging. This case report details successful perioperative management of a patient with the prothrombin 20210A mutation during aortic valve replacement.
Area of Science:
- Cardiology
- Hematology
- Genetics
Background:
- Hypercoagulable states present significant challenges for patients undergoing cardiac surgery.
- Preoperative screening for hypercoagulable disorders offers insights but lacks established hematologic management guidelines.
- Limited prospective studies or case reports hinder preoperative planning for these complex cases.
Observation:
- This report documents the first case of a patient with the prothrombin 20210A mutation undergoing elective aortic valve replacement.
- The patient's hypercoagulable state due to the prothrombin 20210A mutation required careful perioperative consideration.
Findings:
- Successful perioperative management was achieved through specific hematologic strategies.
- Key features included peri-procedural bridging with heparin therapy.
- Avoidance of antifibrinolytic agents was crucial for successful outcomes.
Implications:
- This case highlights the importance of tailored hematologic management in patients with genetic hypercoagulable disorders undergoing cardiac surgery.
- It provides a valuable reference for managing similar complex cases in clinical practice.
- Further research into consensus guidelines for perioperative anticoagulation in such patients is warranted.
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