Ascending Aortic Replacement for Acute Type A Aortic Dissection in a Patient with Anti-phospholipid Antibody Syndrome / 日本心臓血管外科学会雑誌

ABSTRACT

Anti-phospholipid antibody syndrome (APLS) is characterized by the presence of anti-phospholipid antibodies, arterial or venous thrombosis, recurrent abortion, and thrombocytopenia. Although heart valve abnormalities are found in most patients with APLS, acute type A dissection associated with APLS is rare. A 44-year-old woman with systemic lupus erythematosus and APLS, who had been treated with corticosteroids, immunosuppressive agents, and warfarin, was admitted with severe back pain. Computed tomography demonstrated aortic dissection extending from the ascending to the abdominal aorta. Emergency ascending aorta replacement was performed. The hypercoagulation associated with APLS made it difficult to achieve optimal postoperative anticoagulant control. Moreover, corticosteroids and immunosuppressive agents may result in postoperative infection. However, this patient was discharged without complications 14 days after the operation.