title: [Prophylaxis of perioperative pulmonary thromboembolism in a patient with anti-phospholipid antigen syndrome].
abstract: A 68-year-old woman with anti-phospholipid antigen syndrome (APS) was proposed to undergo partial pulmonary resection for lung cancer. She suffered from mild cerebellar ataxia. Exercised 201Tl myocardial scintigraphy was performed due to abnormal Q wave in preoperative electrocardiography and showed old myocardial infarction in inferior-to-posterior area without myocardial ischemia. Cardiac function was marginally decreased in cardiac echographic evaluation. Arterial thrombosis by APS might cause cerebellar ataxia and myocardial infarction. Low molecular weight heparin (LMWH) was continuously infused from 1 hour prior to arrival in an operation room. Elastic stockings (ES) were worn from the morning of the operation in combination with the use of intermittent pneumatic compression apparatus (IPC). Significant bleeding was not observed perioperatively. Hypothermia was avoided by forced-air-warming therapy. She was transferred to ICU after the end of the operation. She was returned to her ward without IPC on the first postoperative day. Warfarin was given with the beginning of ambulation on the second postoperative day to keep PT-INR about 2. On the third postoperative day LMWH was discontinued and ES were taken off. The postoperative course was uneventful.
authors.affiliation: Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537 8511.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ebina
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kishi
authors.forename: Mika
authors.initials: M
authors.lastname: Baba
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kitamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iritakenishi
authors.forename: Michioki
authors.initials: M
authors.lastname: Kuri
authors.forename: Noriko
authors.initials: N
authors.lastname: Kanbara
authors.forename: Hironobu
authors.initials: H
authors.lastname: Tanigami
authors.forename: Masahiko
authors.initials: M
authors.lastname: Higashiyama
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D016736:Antiphospholipid Syndrome / Q000150:complications*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D019990:Perioperative Care; D011013:Pneumonectomy; D011655:Pulmonary Embolism / Q000517:prevention & control*
chemical_list: D006495:Heparin, Low-Molecular-Weight