Management of a patient with lupus anticoagulant and antiphospholipid syndrome for off-pump coronary artery bypass grafting using the Hepcon system.
Patients with serum lupus anticoagulant antibodies (LAC) with or without antiphospholipid syndrome who present for cardiac surgery provide a unique set of challenges. Chief among these are the interference with anticoagulation monitoring by LAC. We present a case of such a patient who presented to us for coronary artery bypass grafting. We follow with a review of LAC and antiphospholipid syndrome and present a strategy for ensuring adequate anticoagulation during cardiac surgery in the background of previously published reports.
Jervis
Karinne
K
Department of Anesthesia, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
Senthilnathan
Venkatachalam
V
Lerner
Adam B
AB
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000276:immunology; D001777:Blood Coagulation / Q000187:drug effects; D001780:Blood Coagulation Tests / Q000295:instrumentation*; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000601:surgery*; D016903:Drug Monitoring / Q000295:instrumentation*; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D016896:Treatment Outcome
D000925:Anticoagulants; D016682:Lupus Coagulation Inhibitor; D006493:Heparin