title: Factor V Leiden and Cardiopulmonary Bypass.
abstract: We present a case of a patient with factor V Leiden with an antithrombin III activity of 67% who received a successful aortic valve replacement supported by cardiopulmonary bypass (CPB). A safe level of anticoagulation was achieved by monitoring activated clotting time (ACT) and heparin concentration ensuring adequate anticoagulation throughout the procedure. Results from ACT, heparin dose response, heparin protamine titration, and thrombelastography are given. Factor V Leiden patients can be safely anti-coagulated using heparin for CPB procedures when monitored with ACT, heparin protamine titration, and thrombelastography. Postoperative chest tube losses were 360 mL, less than half our institutional average. Anticoagulation for the pre-and post-operative phase is also discussed.
authors.affiliation: Royal University Hospital, Saskatoon, Saskatchewan, Canada.
authors.forename: Victor
authors.initials: V
authors.lastname: Uppal
authors.affiliation: Royal University Hospital, Saskatoon, Saskatchewan, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Rosin
authors.affiliation: Royal University Hospital, Saskatoon, Saskatchewan, Canada.
authors.forename: Jo-Anne
authors.initials: JA
authors.lastname: Marcoux
authors.affiliation: Royal University Hospital, Saskatoon, Saskatchewan, Canada.
authors.forename: Marnie
authors.initials: M
authors.lastname: Olson
authors.affiliation: Royal University Hospital, Saskatoon, Saskatchewan, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bezaire
authors.affiliation: Royal University Hospital, Saskatoon, Saskatchewan, Canada.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dalshaug
mesh_terms: D020016:Activated Protein C Resistance; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D001780:Blood Coagulation Tests; D002315:Cardiopulmonary Bypass; D005165:Factor V; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D013927:Thrombosis / Q000188:drug therapy / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V
keywords: anticoagulation; cardiopulmonary bypass; factor V Leiden
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