Coronary artery bypass grafting in a patient with protein S deficiency: perioperative implications

Area of Science:

• Hematology
• Cardiovascular Surgery
• Thrombosis Research

Background:

• Protein S (PS) deficiency is linked to abnormal clot formation and necessitates anticoagulation.
• Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) face heightened thrombotic risks.
• Heparin resistance is uncommon in this patient group, particularly with normal antithrombin levels.

Observation:

• A patient with type I Protein S deficiency and unexpected heparin resistance underwent coronary artery bypass grafting with CPB.
• Managing CPB in patients with both PS deficiency and heparin resistance is clinically challenging.

Findings:

• The study details the perioperative management strategies employed for this complex patient case.
• Successful CPB management was achieved despite the patient's rare combination of PS deficiency and heparin resistance.

Implications:

• This case highlights the importance of recognizing and managing rare coagulation disorders during high-risk surgeries.
• Effective strategies for CPB management in patients with PS deficiency and heparin resistance can be extrapolated to similar clinical scenarios.
• Further research into anticoagulation protocols for patients with combined PS deficiency and heparin resistance is warranted.