Management of Anticoagulation and Antifibrinolytics in Catastrophic Antiphospholipid Syndrome.
Semin Cardiothorac Vasc Anesth
; 28(3): 181-187, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-38705843
ABSTRACT
Antiphospholipid syndrome (APS) is an autoimmune disorder that presents with hypercoagulability and results in a lab artifact of prolonged PTT. The most severe form is catastrophic antiphospholipid antibody syndrome (CAPS), which manifests as rapidly progressing thromboses in multiple organ systems leading to multi-organ ischemia. The mainstay management CAPS is anticoagulation and systemic corticosteroids. Antifibrinolytic agents have previously been thought to be relatively contraindicated in CAPS due to the pro-thrombotic nature of the disease; the complex coagulation profile of CAPS can make it difficult to assess the risks and benefits of antifibrinolytic therapy. Also, should a patient with CAPS require cardiopulmonary bypass (CPB) for surgery, it poses a unique challenge in providing appropriate anticoagulation in the setting of prolonged ACT. We present a case of a 32-year-old postpartum female with CAPS requiring heart transplant who safely received intraoperative antifibrinolytic therapy and was successfully anticoagulated during CPB after perioperative plasmapheresis.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Puente Cardiopulmonar
/
Síndrome Antifosfolípido
/
Anticoagulantes
/
Antifibrinolíticos
Límite:
Adult
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Female
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Humans
Idioma:
En
Revista:
Semin Cardiothorac Vasc Anesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos