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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...

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Detalles Bibliográficos
Autores principales: Nishimura, Yoshiyuki, Takagi, Yasushi
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
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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.
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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
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