Coronary artery bypass grafting in 2 thrombophilic patients with protein s deficiency

Area of Science:

• Cardiology
• Hematology

Background:

• Coronary artery disease (CAD) poses significant risks.
• Protein S deficiency is a hypercoagulable condition impacting surgical outcomes.
• Managing anticoagulation in CAD patients with protein S deficiency is complex.

Purpose of the Study:

• To review two cases of coronary revascularization in patients with protein S deficiency.
• To evaluate the efficacy of fresh frozen plasma in normalizing protein S levels preoperatively.
• To assess the safety and outcomes of avoiding intraoperative antifibrinolytic treatment.

Main Methods:

• Case report review of two patients undergoing coronary revascularization.
• Use of fresh frozen plasma as cardiopulmonary bypass priming fluid to address protein S deficiency.
• Monitoring for perioperative bleeding and thrombotic complications.

Main Results:

• Fresh frozen plasma effectively normalized protein S levels prior to extracorporeal circulation.
• Neither patient experienced perioperative thrombotic complications.
• Absence of intraoperative antifibrinolytic treatment was well-tolerated.

Conclusions:

• Fresh frozen plasma is a viable strategy for managing protein S deficiency during coronary revascularization.
• Coronary revascularization can be safely performed in patients with protein S deficiency.
• Avoiding antifibrinolytics may be feasible in select cases, balancing bleeding and thrombosis risks.