Cardiac transplantation in patients with anti-phospholipid antibodies.
Patients with severe heart failure are known to have an increased incidence of thromboembolic events and frequently have a visible thrombus in the left ventricle. Thromboemboli in heart failure patients are usually attributed to the underlying heart failure, and alternative etiologies for thrombus formation are rarely sought. However, anti-phospholipid antibodies and other inherited or acquired clotting abnormalities may contribute to hypercoagulability in heart failure patients and can lead to a persistent high risk for clotting, even after heart transplantation has corrected the underlying heart failure. We report outcomes with heart transplantation in 3 young patients with anti-phospholipid antibodies and a history of pre-heart transplantation thromboembolic events, and demonstrate the importance of post-heart transplantation anti-coagulation in these patients.
Schofield
Richard S
RS
Department of Veterans Affairs Medical Center, Gainesville, Florida, USA. schofrs@medicine.ufl.edu
Aranda
Juan M
JM
Shoemaker
Steven B
SB
Pauly
Daniel F
DF
Hill
James A
JA
Klodell
Charles T
CT
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D000925:Anticoagulants / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000150:complications / Q000209:etiology / Q000276:immunology* / Q000601:surgery*; D002311:Cardiomyopathy, Dilated / Q000150:complications; D003327:Coronary Disease / Q000188:drug therapy / Q000209:etiology; D004617:Embolism / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008499:Medical Records; D011182:Postoperative Care; D020521:Stroke / Q000209:etiology; D013923:Thromboembolism / Q000150:complications / Q000209:etiology
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants