Intracardiac thrombosis and acute right ventricular failure following complex reoperative cardiac surgery with aprotinin and deep hypothermic circulatory arrest.
Although coagulopathy and bleeding are common in the setting of cardiac surgery, a growing number of case reports in the literature suggest that hypercoagulability may also result in significant morbidity and mortality. We present a case of apparent hypercoagulability with formation of thrombus in the cardiac chambers following reoperative cardiac surgery using cardiopulmonary bypass, aprotinin, and deep hypothermic arrest. A review of those hypercoagulable disorders with reported impact on cardiac surgery and a discussion follow the case presentation.
Stone
Marc E
ME
Mount Sinai School of Medicine, New York, New York 10029-6574, USA. marc.stone@mountsinai.org
Silverman
Scott H
SH
Nomoto
Koichi
K
D000368:Aged; D001018:Aortic Diseases / Q000150:complications / Q000601:surgery; D007611:Aprotinin / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D050792:Circulatory Arrest, Deep Hypothermia Induced; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery; D003328:Coronary Thrombosis / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology*; D012086:Reoperation; D019851:Thrombophilia / Q000097:blood / Q000150:complications; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000209:etiology* / Q000503:physiopathology
D006490:Hemostatics; D007611:Aprotinin