Cardiopulmonary bypass with deep hypothermic circulatory arrest for a patient with sickle cell anemia: a case report.
A 36-year-old sickle cell anemia patient undergoing a pulmonary thromboendarterectomy required the use of cardiopulmonary bypass incorporating deep hypothermic circulatory arrest. Being aware of reported incidences of sickling crises, a team of the surgeon, anesthesiologist, hematologist, and perfusionist met to devise a plan of treatment. Treatment included preoperative and intraoperative exchange transfusion, optimal blood gas management, and increased blood flows during bypass. The surgical procedure was performed and was successful in reducing pulmonary hypertension, incorporating a team approach and utilizing these techniques. No incidence of adverse sickling events was observed during this procedure.
Vocelka
C R
CR
Division of Cardiothoracic Surgery, Department of Surgery, University of Washington, Seattle 98195, USA. vocelka@u.washington.edu
Lindley
G G
GG
Mulligan
M S
MS
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D004691:Endarterectomy / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000517:prevention & control*; D007036:Hypothermia, Induced; D007430:Intraoperative Care / Q000379:methods; D010347:Patient Care Planning; D011651:Pulmonary Artery / Q000601:surgery; D016896:Treatment Outcome