title: Management of a Patient With Antiphospholipid Syndrome Undergoing Aortic Valve Replacement Using the Hepcon Hemostasis Management System Plus and Rotational Thromboelastometry: A Case Report.
abstract: A 72-year-old woman with antiphospholipid syndrome underwent aortic valve replacement. Her preoperative activated partial thromboplastin time was 61.7 seconds and activated clotting time was 219 seconds. During cardiopulmonary bypass, the Hepcon Hemostasis Management System (HMS) Plus determined the heparin dose needed to maintain whole-body heparin at 3 U/mL. After cardiopulmonary bypass, 100 mg of protamine was administered based on heparin-protamine neutralization, and the activated clotting time decreased. We applied rotational thromboelastometry (ROTEM) to diagnose residual heparin using the INTEM/HEPTEM clotting time ratio. The HMS and ROTEM are useful for heparin-protamine control in antiphospholipid syndrome.
authors.affiliation: From the Department of Anesthesiology, School of Medicine, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Samejima
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Kodaka
authors.forename: Junko
authors.initials: J
authors.lastname: Ichikawa
authors.forename: Tetsu
authors.initials: T
authors.lastname: Mori
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ando
authors.forename: Keiko
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Makiko
authors.initials: M
authors.lastname: Komori
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D054796:Drug Dosage Calculations; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006487:Hemostasis; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D010314:Partial Thromboplastin Time; D013916:Thrombelastography; D014914:Whole Blood Coagulation Time
chemical_list: D000925:Anticoagulants; D006493:Heparin