Cardiac transplantation in a patient with protein S deficiency.
Cardiac transplantation was successfully performed in a patient with end-stage ischemic cardiomyopathy and hereditary protein S deficiency who had undergone two previous coronary artery bypass graft procedures. Routine intraoperative heparinization and reversal with protamine was undertaken, and the antifibrinolytic agent aprotinin was infused throughout the procedure without perioperative hemorrhage or thrombosis. Systemic anticoagulation with intravenous heparin was resumed on postoperative day 2, and the patient was then converted to Lovenex as outpatient anticoagulation to facilitate routine surveillance endomyocardial biopsies.
Spanier
T B
TB
Department of Surgery, Columbia University College of Physicians & Surgeons, New York, New York, USA. tbs8@columbia.edu
Chen
J M
JM
Mancini
D M
DM
Smith
C R
CR
Edwards
N M
NM
D000925:Anticoagulants / Q000008:administration & dosage; D007611:Aprotinin / Q000008:administration & dosage; D009202:Cardiomyopathies / Q000150:complications / Q000601:surgery*; D016027:Heart Transplantation; D006490:Hemostatics / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D018455:Protein S Deficiency / Q000150:complications / Q000235:genetics
D000925:Anticoagulants; D006490:Hemostatics; D006493:Heparin; D007611:Aprotinin