Abstract
BackgroundAntiphospholipid syndrome (APS) is a rare coagulation disorder associated with thrombotic events, myocardial infarction, and valvular heart disease. During valvular replacement surgery, the high risk of thrombosis combined with the operative risks in these specific groups of patients poses a challenge to the medical team.Case presentationWe present a case of a female patient with APS and mixed aortic valve disease. During surgery, she suddenly developed complete cardiac arrest. Three months later, after she recovered, and while she was still on close follow up, a thrombotic event caused myocardial infarction. After prompt and precise treatment, the patient successfully recovered; one year after surgery patient is doing well.ConclusionAdequate surgical technique along with optimal anticoagulation strategies and long term follow up are of paramount importance to ensure an uneventful recovery. A multidisciplinary team is required to manage these complex scenarios and high-risk patients.
Highlights
Antiphospholipid syndrome (APS) is a rare coagulation disorder associated with thrombotic events, myocardial infarction, and valvular heart disease
Case presentation Patient is a petite 35-year-old vegan female with past medical history of systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and deep vein thrombosis complicated with pulmonary embolism for which she received rivaroxaban
Antiphospholipid syndrome (APS) is an immunemediated acquired thrombophilia characterized by venous and arterial thrombosis, fetal losses, thrombocytopenia and the presence of antiphospholipid antibodies, in some patients, this syndrome can be associated with systemic lupus erythematosus (SLE) [1, 2]
Summary
APS is a complex disease that must be managed by a multidisciplinary team of surgeons, physicians, and hematologists, given the severe spectrum of cardiac complications that this disease can exhibit precise surgical skills, a close follow-up and precise anticoagulant treatment are crucial to improve the patient’s outcome when these rare scenarios arise. After the surgery and discharge, she gained more confidence and as she was feeling well, she partially ignored her diet and his anticoagulant therapy. After her last cardiac event, she realized how important her therapy is, and is on close follow-ups
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