Subject(s)
Anticoagulants/adverse effects , Anticoagulants/therapeutic use , Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/surgery , Cardiac Surgical Procedures , Cardiopulmonary Bypass , Heart Valve Prosthesis Implantation , Humans , International Normalized Ratio , Intraoperative Complications/epidemiology , Intraoperative Complications/prevention & control , Myocardial Revascularization , Perioperative Period , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Postoperative Hemorrhage/prevention & control , Postoperative Hemorrhage/therapy , Thrombosis/prevention & control , Thrombosis/therapyABSTRACT
Antiphospholipid antibody syndrome (APLAS) characterises a clinical condition of arterial and venous thrombosis associated with phospholipids directed antibodies. APLAS occurs in 2% of the general population. However, one study demonstrated that 7.1% of hospitalised patients were tested positive for at least one of the three anticardiolipin antibody idiotype. Antiphospholipid antibodies often inhibit phospholipids dependent coagulation in vitro and interfere with laboratory testing of hemostasis. Therefore, the management of anticoagulation during cardiopulmonary bypass can be quite challenging in these patients. Here, we present a case of right atrial mass removal and pulmonary thrombectomy in a patient of APLAS.
Subject(s)
Adult , Anesthesia/methods , Antiphospholipid Syndrome/surgery , Echocardiography, Transesophageal , Female , Heart Atria , Humans , Pulmonary Artery/surgery , Pulmonary Embolism/surgery , ThrombectomyABSTRACT
La asociación de vasculitis con enfermedades del tejido conectivo es bien conocida y con frecuencia producen eventos oclusivos vasculares; informamos los casos de un paciente con lupus eritematoso sistémico y otro con artritis reumatoidea, con vasculitis reumatoidea y síndrome antifosfolípido secundario, que desarrollaron oclusión arterial en miembros inferiores y que requirieron amputación en quienes se documentó la presencia de vasculitis, vasculopatía y trombo organizado. La pérdida dramática de tejido es rara para vasculitis aislada o síndrome antifosfolípido primario. Sugerimo en pacientes con estas enfermedades que cursen con compromiso vascular rápidamete progresivo sospechar la asociación de vasculitis y trombosis e iniciar manejo agresivo con inmunosupresores, antiagregantes plaquetarios y vasodilatadores