Cargando…
Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency
Antithrombin III (ATIII) deficiency is a rare disorder in which thrombosis can be induced by stimuli that do not usually lead to thrombus formation, including minor injuries and surgery. Therefore, patients with ATIII deficiency undergoing cardiovascular surgery that involves heparinization require...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102604/ https://www.ncbi.nlm.nih.gov/pubmed/29681597 http://dx.doi.org/10.5761/atcs.oa.18-00030 |
_version_ | 1783349201973805056 |
---|---|
author | Nishimura, Yoshiyuki Takagi, Yasushi |
author_facet | Nishimura, Yoshiyuki Takagi, Yasushi |
author_sort | Nishimura, Yoshiyuki |
collection | PubMed |
description | Antithrombin III (ATIII) deficiency is a rare disorder in which thrombosis can be induced by stimuli that do not usually lead to thrombus formation, including minor injuries and surgery. Therefore, patients with ATIII deficiency undergoing cardiovascular surgery that involves heparinization require careful perioperative management. We experienced five patients with ATIII deficiency who underwent cardiovascular surgery and were managed with ATIII replacement. By administration of ATIII concentrate, preoperative ATIII activity was maintained at ≥120% and postoperative ATIII activity at ≥80%. All five patients were treated successfully without postoperative complications such as hemorrhage or thrombosis. In patients with ATIII deficiency undergoing cardiac surgery, it is important to perform ATIII replacement to achieve preoperative ATIII activity ≥120% and postoperative ATIII activity ≥80%, while the activated clotting time (ACT) is maintained at >400 seconds during cardiopulmonary bypass. In addition, long-term postoperative anticoagulant therapy is necessary in hereditary ATIII deficiency patients with a history of thrombosis. |
format | Online Article Text |
id | pubmed-6102604 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-61026042018-08-23 Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency Nishimura, Yoshiyuki Takagi, Yasushi Ann Thorac Cardiovasc Surg Original Article Antithrombin III (ATIII) deficiency is a rare disorder in which thrombosis can be induced by stimuli that do not usually lead to thrombus formation, including minor injuries and surgery. Therefore, patients with ATIII deficiency undergoing cardiovascular surgery that involves heparinization require careful perioperative management. We experienced five patients with ATIII deficiency who underwent cardiovascular surgery and were managed with ATIII replacement. By administration of ATIII concentrate, preoperative ATIII activity was maintained at ≥120% and postoperative ATIII activity at ≥80%. All five patients were treated successfully without postoperative complications such as hemorrhage or thrombosis. In patients with ATIII deficiency undergoing cardiac surgery, it is important to perform ATIII replacement to achieve preoperative ATIII activity ≥120% and postoperative ATIII activity ≥80%, while the activated clotting time (ACT) is maintained at >400 seconds during cardiopulmonary bypass. In addition, long-term postoperative anticoagulant therapy is necessary in hereditary ATIII deficiency patients with a history of thrombosis. The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery 2018-04-20 2018 /pmc/articles/PMC6102604/ /pubmed/29681597 http://dx.doi.org/10.5761/atcs.oa.18-00030 Text en ©2018 Annals of Thoracic and Cardiovascular Surgery http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NonDerivatives International License (http://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Original Article Nishimura, Yoshiyuki Takagi, Yasushi Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency |
title | Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency |
title_full | Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency |
title_fullStr | Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency |
title_full_unstemmed | Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency |
title_short | Strategy for Cardiovascular Surgery in Patients with Antithrombin III Deficiency |
title_sort | strategy for cardiovascular surgery in patients with antithrombin iii deficiency |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102604/ https://www.ncbi.nlm.nih.gov/pubmed/29681597 http://dx.doi.org/10.5761/atcs.oa.18-00030 |
work_keys_str_mv | AT nishimurayoshiyuki strategyforcardiovascularsurgeryinpatientswithantithrombiniiideficiency AT takagiyasushi strategyforcardiovascularsurgeryinpatientswithantithrombiniiideficiency |