title: [Hereditary thrombophilia in free microvascular flaps--a case report].
abstract: Hereditary thrombophilia sums up a large number of haemostatic disorders, which cause thrombosis independently to external influences. The main cases of hereditary thrombophilias are the hereditary antithrombin defect, the activated protein C resistance, the hereditary protein C defect, the hereditary protein S defect, the antiphospholipid antibody syndrome, the hyperhomocysteinaemia, the increased factor VIII activity and the prothrombin-G20210A-polymorphism. We present a patient who was amputated in both breasts due to cancer. A bilateral microvascular TRAM-flap was planned as primary reconstruction on one breast and secondary reconstruction on the other breast. However in the operation the flap vessels revealed irreversible thromboses so that the intended reconstruction could not be completed in this operation. Postoperatively, a combined hereditary thrombophilia was diagnosed: heterocygote activated protein C resistance, antiphospholipid antibody syndrome and hyperhomocysteinaemia.
authors.affiliation: Klinik für Plastische, Rekonstruktive und Asthetische Chirurgie, Handchirurgie, Städtische Kliniken Bielefeld Mitte, Bielefeld. imke.warnecke@sk-bielefeld.de
authors.forename: I C
authors.initials: IC
authors.lastname: Warnecke
authors.forename: F
authors.initials: F
authors.lastname: Kretschmer
authors.forename: S
authors.initials: S
authors.lastname: Brüner
authors.forename: O
authors.initials: O
authors.lastname: Frerichs
authors.forename: H
authors.initials: H
authors.lastname: Fansa
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005165:Factor V / Q000235:genetics*; D005260:Female; D006580:Genetic Carrier Screening; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000628:therapy; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008866:Microsurgery; D008875:Middle Aged; D009154:Mutation; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D013524:Surgical Flaps / Q000098:blood supply*; D019851:Thrombophilia / Q000150:complications / Q000175:diagnosis / Q000235:genetics*
chemical_list: C095381:factor V Leiden; D005165:Factor V