Implications for cardiac surgery in patients with factor XII deficiency.
Factor XII deficiency is associated with a prolonged activated partial thromboplastin time and activated clotting time used for monitoring during cardiopulmonary bypass. It does not predispose to an increased risk of bleeding. We present the strategy used for a case of coronary artery bypass grafting in a patient with factor XII deficiency, followed by a brief discussion of the important clinical considerations when patients with factor XII deficiency undergo cardiac surgery. Monitoring of heparin and the avoidance of anti-fibrinolytic agents are the main intraoperative issues. Postoperative care must include careful thromboembolic prophylaxis and vigilance against infection.
Conaglen
Paul J
PJ
Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia. paulandsarahconaglen@yahoo.co.nz
Akowuah
Enoch
E
Theodore
Sanjay
S
Atkinson
Victoria
V
D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000097:blood* / Q000601:surgery*; D003646:Debridement; D004927:Escherichia coli Infections / Q000097:blood / Q000601:surgery; D005175:Factor XII Deficiency / Q000097:blood*; D015951:Factor Xa / Q000032:analysis; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007431:Intraoperative Complications / Q000097:blood*; D008297:Male; D010314:Partial Thromboplastin Time; D010949:Plasma; D012086:Reoperation; D013249:Sternum / Q000601:surgery; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000097:blood / Q000601:surgery; D014914:Whole Blood Coagulation Time
D000925:Anticoagulants; D006493:Heparin; D015951:Factor Xa