Acute postoperative biventricular failure associated with antiphospholipid antibody syndrome

Dornan, R.I.P.

doi:10.1093/bja/aeh116

Cited by 27 publications

(41 citation statements)

References 35 publications

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“…(e) Application of less protamine, e.g. by giving half of the calculated dose or no protamine at all [95,98,99,113,126].…”

Section: Intraoperative Management Of Coagulation -A Crucial Problem mentioning

confidence: 99%

“…The baseline is an aggressive intravenous anticoagulation, usually heparin, later followed by oral anticoagulation with vitamin K-antagonists. Steroids, in order to limit the cytokine release and to treat the widespread vasculitis which mimics the cAPLS [128], and plasmapheresis or intravenous gammaglobulins in order to reduce the autoantibody load, improve the outcome [98,129]. The application of cytotoxic drugs, dialysis, fibrinolytics, splenectomy or prostacyclin are described but so far without proven advantage for survival.…”

Section: Intraoperative Management Of Coagulation -A Crucial Problem mentioning

confidence: 99%

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The antiphospholipid syndrome and heart valve surgery

Gorki¹,

Malinovski²,

Stanbridge³

2008

European Journal of Cardio-Thoracic Surgery

125

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The antiphospholipid syndrome (APLS) is a complex autoimmune disease often connected to systemic lupus erythematodes. Main features are thromboses, fetal loss and specific antibodies. The involved autoantibodies are directed against plasma proteins such as beta2glycoprotein1 (beta2GPI) or prothrombin which depend on negatively charged phospholipids. Direct antibodies against phospholipids are of no importance for APLS. Clotting tests such as activated partial thromboplastin time or diluted Russell's viper venom test (dRVVT) can show a prolonged time for coagulation despite a prothrombotic state in vivo but the investigator needs awareness about disturbing phospholipid sources and other influential factors. Enzyme linked immuno sorbent assay tests for antibodies against cardiolipin, beta2GPI and prothrombin are valuable solid phase tests with different specificity. Antiphospholipid, anticardiolipin or lupus anticoagulant are misnomers in connection with APLS. They are preserved as a reminiscence of the pioneering work on the way to the still not exactly revealed basics of APLS. Valve operations in APLS patients seem to be rare; a meta-analysis of 57 cases proves that the perioperative management is, at the moment, an empirical approach with high morbidity and mortality in these young patients.

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“…(e) Application of less protamine, e.g. by giving half of the calculated dose or no protamine at all [95,98,99,113,126].…”

Section: Intraoperative Management Of Coagulation -A Crucial Problem mentioning

confidence: 99%

Section: Intraoperative Management Of Coagulation -A Crucial Problem mentioning

confidence: 99%

The antiphospholipid syndrome and heart valve surgery

Gorki¹,

Malinovski²,

Stanbridge³

2008

European Journal of Cardio-Thoracic Surgery

125

View full text Add to dashboard Cite

show abstract

“…This is often the case with patients who are on ECMO. A few cases have been documented in the literature where concurrent plasmapheresis and ECMO therapy were well tolerated in these patients [133,134]. Apheresis in conjunction with ECMO has safely been performed in children with weight 10 kg [135].…”

Section: Concurrent Therapeutic Apheresis and Other Extracorporeal Thmentioning

confidence: 99%

Clinical applications of therapeutic apheresis

Balogun

Kaplan

Ward

et al. 2010

J of Clinical Apheresis

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“…APS often results in multi-organ dysfunctions, such as hyperthyroidism, Addison's disease, heart failure and so on [3][4][5]. Heart failure associated with APS often involves the right heart, which is due to pulmonary thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Heart failure with multi-organ thrombosis: a case of antiphospholipid syndrome co-existing with cardiomyopathy

Zhong¹,

Yang²,

Li³

et al. 2012

RusOMJ

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Antiphospholipid Syndrome (APS) is an autoimmune disease featured by venous or arterial thrombosis, fetal losses and thrombocytopenia in the presence of antiphospholipid antibodies. Here we reported one case of antiphospholipid syndrome together with dilated cardiomyopathy. A 46-year-old female patient complaining short of breath was found enlargement of atrial and ventricular compartments. The ecletrocardiogram and blood test revealed anteroseptal myocardial infarction, while no pulmonary thrombosis was present and therefore diagnosis of dilated cardiomyopathy was made. There were also thrombi formed in the cardial chambers and deep venous. During hospitalization, there was an onset of ischemic brain stroke and head MRI showed newly developed small infarctions. An elevation of anticardiolipin immunoglobulin A (ACAIGA) was detected from the blood sample. The patient was discharged after being treated with anticoagulant, corticosteroid and other medicines for improving heart function. In our case, APS is the basic cause leading to multi-organ thrombosis and heart failure is mainly due to dilated cardiomyopathy, thus independent of APS. So this is the first time that cardiomyopathy co-existing with APS was reported.

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Acute postoperative biventricular failure associated with antiphospholipid antibody syndrome

Cited by 27 publications

References 35 publications

The antiphospholipid syndrome and heart valve surgery

The antiphospholipid syndrome and heart valve surgery

Clinical applications of therapeutic apheresis

Heart failure with multi-organ thrombosis: a case of antiphospholipid syndrome co-existing with cardiomyopathy

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