title: Cold Agglutinin Autoantibodies in a Patient without a Visible Coronary Sinus Ostium: Strategies for Myocardial Protection without Using Retrograde Cardioplegia.
abstract: The presence of cold agglutinins (CA) during cardiac surgery with cardiopulmonary bypass usually creates the need for an altered surgical plan. In this case, the CA were discovered after the initiation of bypass, limiting the time, and cardioplegia solutions that could be used in the new approach. The inability to cannulate the coronary sinus with a retrograde cardioplegia catheter excluded the standard approach to myocardial preservation with CA of using continuous warm blood. For this case, we used intermittent cold crystalloid delivered via the antegrade needle for the first half of the procedure and through the saphenous vein graft anastomosis during the aortic valve portion of the cross-clamp period.
authors: Durham VA Medical Center, Durham, North Carolina; and.
authors: Michele
authors: M
authors: Heath
authors: Duke University Hospital, Durham, North Carolina.
authors: Suraj
authors: S
authors: Yalamuri
authors: Durham VA Medical Center, Durham, North Carolina; and.
authors: Julie
authors: J
authors: Walker
authors: Durham VA Medical Center, Durham, North Carolina; and; Duke University Hospital, Durham, North Carolina.
authors: Cory
authors: C
authors: Maxwell
authors: Durham VA Medical Center, Durham, North Carolina; and; Duke University Hospital, Durham, North Carolina.
authors: Adam
authors: A
authors: Williams
authors: Duke University Hospital, Durham, North Carolina.
authors: Sharon
authors: S
authors: McCartney
authors: Durham VA Medical Center, Durham, North Carolina; and; Duke University Hospital, Durham, North Carolina.
authors: Mani
authors: M
authors: Daneshmand
mesh_terms: D001323:Autoantibodies; D002314:Cardioplegic Solutions; D001026:Coronary Artery Bypass; D054326:Coronary Sinus; D006324:Heart Arrest, Induced; D006801:Humans
chemical_list: D001323:Autoantibodies; D002314:Cardioplegic Solutions
keywords: antibody/antigen; cardioplegia; coronary sinus; hematology