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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

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Hyperhomocysteinemia, antithrombin consumption, and early venous graft closure in surgical coronary revascularization

M Ranucci1, F Romitti, E Costa

  • 1Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, Polyclinic Hospital S. Donato IRCCS, Milan, Italy. cardioanestesia@virgilio.it

Minerva Anestesiologica
|July 10, 2008
PubMed

Insights

This case report highlights how hyperhomocysteinemia, a condition linked to increased cardiovascular risk, may contribute to thrombosis after cardiac surgery. Low antithrombin activity was observed post-operation in a patient with this condition.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Genetics

Background:

  • Hyperhomocysteinemia elevates cardiovascular risk due to prothrombotic effects.
  • Cardiac surgery and hyperhomocysteinemia can independently increase thrombin generation.

Observation:

  • A 61-year-old man experienced early venous graft thrombosis after coronary revascularization.
  • Postoperative antithrombin activity was significantly reduced (33%) compared to preoperative levels (79%).

Findings:

  • The patient was diagnosed with hyperhomocysteinemia (18.4 mmol/L) due to a heterozygous C677T methylenetetrahydrofolate reductase mutation and folate deficiency.
  • Combined factors of hyperhomocysteinemia and cardiac surgery likely led to antithrombin consumption and thrombosis.

Implications:

  • This case suggests a potential link between hyperhomocysteinemia and thrombotic events post-cardiac surgery.
  • Further research is required to establish hyperhomocysteinemia as an independent risk factor for thrombosis after cardiac operations.

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