Antiphospholipid syndrome and perioperative hemostatic management of cardiac valvular surgery.
Hemostatic aspects of antiphospholipid syndrome (APS) present unique challenges to clinicians and laboratory personnel alike, particularly in the perioperative period. These challenges are especially evident in patients requiring cardiac valve replacement surgery. However, the literature outlining the optimal approach in such patients is limited. We present the case of a 25-year-old woman with severe aortic regurgitation as a result of APS with particular reference to the precautions necessary during perioperative care. Particularly important are the prevention of thrombotic or hemorrhagic complications, management of associated thrombocytopenia, and laboratory methods of perioperative anticoagulation monitoring in the setting of prolonged clotting times.
Hogan
W J
WJ
Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
McBane
R D
RD
Santrach
P J
PJ
Plumhoff
E A
EA
Oliver
W C
WC
Schaff
H V
HV
Rodeheffer
R J
RJ
Edwards
W D
WD
Duffy
J
J
Nichols
W L
WL
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D001780:Blood Coagulation Tests; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006488:Hemostasis, Surgical / Q000379:methods; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D013921:Thrombocytopenia / Q000209:etiology / Q000517:prevention & control; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants; D006493:Heparin