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Changes in coagulation factor XII and its function during aortic arch surgery for acute aortic dissection-a
Jiachen Li1,2,3,4, Xinliang Guan1,2,3,4, Ou Liu1,2,3,4
1Department of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100069, China.
Journal of Thoracic Disease
|September 4, 2018
Summary
Coagulation factor XII levels significantly decrease during aortic arch surgery and correlate with reoperation for coagulopathy. Supplementing factor XII may offer future treatment for surgical coagulopathy.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Coagulation Science
Background:
- Intrinsic coagulation pathway changes during aortic arch surgery for acute aortic dissection (AAD) remain unreported.
- Investigating coagulation factor XII (FXII) function is crucial for managing surgical coagulopathy.
Purpose of the Study:
- To describe FXII level alterations during AAD surgery.
- To explore FXII's role in perioperative coagulopathy.
- To identify potential therapeutic targets for coagulopathy.
Main Methods:
- Eighty-eight AAD patients undergoing emergent surgery were enrolled.
- Coagulation factors XII and VII, and upstream factors were measured at five perioperative timepoints.
- Patients were grouped based on the need for reoperation due to coagulopathy.
Main Results:
- Both FXII and factor VII decreased significantly during hypothermia circulation arrest but FXII showed a greater decline (42% vs 20%).
- FXII levels remained lower than preoperative levels 24 hours post-surgery, unlike factor VII which recovered faster.
- Lower FXII levels during hypothermia circulation arrest were an independent risk factor for reoperation for coagulopathy.
Conclusions:
- FXII is significantly affected by aortic arch surgery, with slower recovery than factor VII.
- Perioperative FXII levels, particularly during hypothermia circulation arrest, predict the need for reoperation due to coagulopathy.
- Supplementation of FXII and its upstream factors presents a potential future therapeutic strategy.
Keywords:
Acute aortic dissection (AAD)coagulation factor XIIhypothermia circulation arrestintrinsic coagulation pathwayMore Related Videos
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