Abstract
BackgroundAnticoagulation management of patients with antiphospholipid syndrome (APS) undergoing cardiac surgery is challenging due to the prolongation of activated clotting time (ACT). Currently, no study has compared the utility of ACT monitoring using the Hemochron Jr. Signature+ and that of heparin concentration management using the Hemostasis Management System (HMS) Plus in patients with APS.Case presentationA 71-year-old woman with APS was scheduled to undergo an aortic valve replacement for aortic regurgitation. The ACT was measured using the Hemochron Jr. Signature+, and the heparin concentration was measured concurrently using the HMS Plus. ACT over 480 s corresponded to an adequate heparin concentration during cardiopulmonary bypass. The clinical course was uneventful, and no thrombotic or hemorrhagic complications were observed.ConclusionIn the present patient with APS, the Hemochron Jr. Signature+ was useful as an anticoagulation management during cardiac valve surgery.
Highlights
Anticoagulation management of patients with antiphospholipid syndrome (APS) undergoing cardiac surgery is challenging due to the prolongation of activated clotting time (ACT)
Antiphospholipid syndrome (APS) is an acquired hypercoagulable disorder characterized by arterial and/or venous thrombosis and recurrent fetal losses owing to the presence of antiphospholipid antibodies [1]
* Correspondence: uzotsuka@hotmail.com 1Department of Anesthesiology and Critical Care, Jichi Medical University Saitama Medical Center, 1-847, Amanumacho, Omiya-ku, Saitama-city, Saitama 330-8503, Japan Full list of author information is available at the end of the article attributed to the spontaneous prolongation of coagulation tests, such as activated partial thromboplastin time (APTT) and activated clotting time (ACT) under the influence of antiphospholipid antibodies
Summary
Anticoagulation management of patients with antiphospholipid syndrome (APS) undergoing cardiac surgery is challenging due to the prolongation of activated clotting time (ACT). Conclusion: In the present patient with APS, the Hemochron Jr. Signature+ was useful as an anticoagulation management during cardiac valve surgery. * Correspondence: uzotsuka@hotmail.com 1Department of Anesthesiology and Critical Care, Jichi Medical University Saitama Medical Center, 1-847, Amanumacho, Omiya-ku, Saitama-city, Saitama 330-8503, Japan Full list of author information is available at the end of the article attributed to the spontaneous prolongation of coagulation tests, such as activated partial thromboplastin time (APTT) and activated clotting time (ACT) under the influence of antiphospholipid antibodies.
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